| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.76 | $96.76 | $96.76 | |
Aetna
| Professional | $96.76 | $96.76 | $96.76 | |
CareFirst
| Professional | $143.84 | $143.84 | $161.62 | |
Cigna
| Professional | $98.72 | $98.72 | $98.72 | |
Kaiser Permanente
| Professional | $153.66 | $153.66 | $469.31 | |
United
| Professional | $78.63 | $117.95 | $177.22 |