| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $78.79 | $78.79 | $78.79 | |
Aetna
| Professional | $78.79 | $78.79 | $78.79 | |
CareFirst
| Professional | $82.50 | $82.84 | $101.05 | |
Cigna
| Professional | $71.65 | $71.65 | $71.65 | |
Kaiser Permanente
| Professional | $96.08 | $96.08 | $293.42 | |
United
| Professional | $49.16 | $73.73 | $104.47 |