| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $118.66 | $118.66 | $118.66 | |
Aetna
| Professional | $118.66 | $118.66 | $118.66 | |
CareFirst
| Professional | $119.00 | $119.00 | $152.18 | |
Cigna
| Professional | $133.09 | $133.09 | $133.09 | |
Kaiser Permanente
| Professional | $144.69 | $144.69 | $441.91 | |
United
| Professional | $74.04 | $111.06 | $157.34 |