| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.67 | $75.67 | $75.67 | |
Aetna
| Professional | $75.67 | $75.67 | $75.67 | |
CareFirst
| Professional | $76.00 | $76.00 | $97.04 | |
Cigna
| Professional | $71.13 | $71.13 | $71.13 | |
Kaiser Permanente
| Professional | $92.27 | $92.27 | $281.79 | |
United
| Facility | $187.92 | $187.92 | $187.92 | |
United
| Professional | $47.22 | $70.81 | $121.05 |