| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $93.60 | $93.60 | $93.60 | |
Aetna
| Professional | $93.60 | $93.60 | $93.60 | |
CareFirst
| Professional | $94.00 | $98.41 | $120.04 | |
Cigna
| Professional | $82.49 | $82.49 | $82.49 | |
Kaiser Permanente
| Professional | $114.14 | $114.14 | $348.57 | |
United
| Professional | $58.40 | $87.61 | $122.38 |