| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.33 | $102.33 | $102.33 | |
Aetna
| Professional | $81.28 | $95.50 | $120.23 | |
CareFirst
| Professional | $87.10 | $87.10 | $87.10 | |
Cigna
| Professional | $61.66 | $61.66 | $177.83 | |
Kaiser Permanente
| Professional | $147.91 | $169.82 | $302.00 | |
United
| Facility | $75.86 | $75.86 | $75.86 | |
United
| Professional | $50.12 | $75.86 | $125.89 |