| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.82 | $87.82 | $87.82 | |
Aetna
| Professional | $87.82 | $87.82 | $87.82 | |
CareFirst
| Professional | $88.00 | $88.00 | $112.64 | |
Cigna
| Professional | $72.75 | $72.75 | $72.75 | |
Kaiser Permanente
| Professional | $107.10 | $107.10 | $327.08 | |
United
| Professional | $54.80 | $82.21 | $140.50 |