| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $108.81 | $108.81 | $108.81 | |
Aetna
| Professional | $108.81 | $108.81 | $108.81 | |
CareFirst
| Professional | $109.00 | $109.00 | $139.55 | |
Cigna
| Professional | $124.21 | $124.21 | $124.21 | |
Kaiser Permanente
| Professional | $132.69 | $132.69 | $405.24 | |
United
| Professional | $67.90 | $101.84 | $144.28 |