| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.68 | $45.68 | $45.68 | |
Aetna
| Professional | $45.68 | $45.68 | $45.68 | |
CareFirst
| Professional | $53.36 | $53.36 | $58.58 | |
Cigna
| Professional | $59.25 | $59.25 | $59.25 | |
Kaiser Permanente
| Professional | $55.71 | $55.71 | $170.12 | |
United
| Professional | $28.50 | $42.76 | $60.57 |