| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $59.21 | $59.21 | $59.21 | |
Aetna
| Professional | $59.21 | $59.21 | $59.21 | |
CareFirst
| Professional | $64.92 | $64.92 | $75.94 | |
Cigna
| Professional | $76.81 | $76.81 | $76.81 | |
Kaiser Permanente
| Professional | $72.20 | $72.20 | $220.53 | |
United
| Professional | $36.95 | $55.43 | $78.52 |