| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.45 | $112.45 | $112.45 | |
Aetna
| Professional | $112.45 | $112.45 | $112.45 | |
CareFirst
| Professional | $123.26 | $123.26 | $144.21 | |
Cigna
| Professional | $145.90 | $145.90 | $145.90 | |
Kaiser Permanente
| Professional | $137.12 | $137.12 | $418.78 | |
United
| Professional | $70.17 | $105.25 | $149.11 |