| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $116.06 | $116.06 | $116.06 | |
Aetna
| Professional | $116.06 | $116.06 | $116.06 | |
CareFirst
| Professional | $117.00 | $122.02 | $148.85 | |
Cigna
| Professional | $102.82 | $102.82 | $102.82 | |
Kaiser Permanente
| Professional | $141.53 | $141.53 | $432.23 | |
United
| Professional | $72.42 | $108.63 | $153.88 |