| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.22 | $67.22 | $67.22 | |
Aetna
| Professional | $67.22 | $67.22 | $67.22 | |
CareFirst
| Professional | $68.00 | $68.00 | $86.21 | |
Cigna
| Professional | $72.45 | $72.45 | $72.45 | |
Kaiser Permanente
| Professional | $81.98 | $81.98 | $250.35 | |
United
| Professional | $41.94 | $62.92 | $95.71 |