| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $103.61 | $103.61 | $103.61 | |
Aetna
| Professional | $103.61 | $103.61 | $103.61 | |
CareFirst
| Professional | $108.51 | $108.93 | $132.87 | |
Cigna
| Professional | $88.05 | $88.05 | $88.05 | |
Kaiser Permanente
| Professional | $126.35 | $126.35 | $385.85 | |
United
| Professional | $64.65 | $96.97 | $165.74 |