| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $101.29 | $101.29 | $101.29 | |
Aetna
| Professional | $101.29 | $101.29 | $101.29 | |
CareFirst
| Professional | $106.08 | $106.08 | $106.08 | |
Cigna
| Professional | $57.58 | $57.58 | $57.58 | |
Kaiser Permanente
| Professional | $123.51 | $123.51 | $377.21 | |
United
| Professional | $63.20 | $94.80 | $134.30 |