| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $80.76 | $80.76 | $80.76 | |
Aetna
| Professional | $80.76 | $80.76 | $112.90 | |
CareFirst
| Professional | $131.27 | $131.27 | $134.88 | |
Cigna
| Professional | $92.76 | $92.76 | $92.76 | |
Kaiser Permanente
| Professional | $128.25 | $128.25 | $391.68 | |
United
| Professional | $65.63 | $98.44 | $147.91 |