| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $127.12 | $127.12 | $127.12 | |
Aetna
| Professional | $127.12 | $127.12 | $127.12 | |
CareFirst
| Professional | $128.00 | $128.00 | $128.00 | |
Cigna
| Professional | $141.99 | $141.99 | $141.99 | |
Kaiser Permanente
| Professional | $155.02 | $155.02 | $473.42 | |
United
| Professional | $79.31 | $118.98 | $168.56 |