| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.20 | $64.20 | $64.20 | |
Aetna
| Professional | $30.35 | $64.20 | $64.20 | |
CareFirst
| Professional | $54.05 | $54.05 | $54.05 | |
Cigna
| Professional | $38.77 | $38.77 | $38.77 | |
Kaiser Permanente
| Professional | $90.27 | $188.61 | $188.61 | |
United
| Professional | $31.60 | $47.40 | $83.26 |