| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $54.05 | $54.05 | $54.05 | |
Aetna
| Professional | $54.05 | $54.05 | $54.05 | |
CareFirst
| Professional | $54.00 | $56.83 | $69.31 | |
Cigna
| Professional | $43.95 | $43.95 | $43.95 | |
Kaiser Permanente
| Professional | $65.91 | $65.91 | $201.28 | |
United
| Professional | $33.72 | $50.59 | $71.66 |