| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $76.30 | $76.30 | $76.30 | |
Aetna
| Professional | $76.30 | $76.30 | $106.85 | |
CareFirst
| Professional | $124.04 | $124.04 | $127.44 | |
Cigna
| Professional | $88.19 | $88.19 | $88.19 | |
Kaiser Permanente
| Professional | $121.18 | $121.18 | $370.07 | |
United
| Professional | $62.01 | $93.01 | $139.75 |