| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $84.97 | $84.97 | $84.97 | |
Aetna
| Professional | $84.97 | $84.97 | $84.97 | |
CareFirst
| Professional | $85.00 | $85.00 | $108.97 | |
Cigna
| Professional | $72.50 | $72.50 | $72.50 | |
Kaiser Permanente
| Professional | $103.62 | $103.62 | $316.43 | |
United
| Professional | $53.02 | $79.53 | $135.91 |