| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.23 | $120.23 | $120.23 | |
Aetna
| Professional | $120.23 | $120.23 | $120.23 | |
CareFirst
| Professional | $121.00 | $121.00 | $154.19 | |
Cigna
| Professional | $92.70 | $92.70 | $92.70 | |
Kaiser Permanente
| Professional | $146.62 | $146.62 | $447.76 | |
United
| Professional | $75.02 | $112.54 | $159.43 |