| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $76.02 | $76.02 | $76.02 | |
Aetna
| Professional | $68.92 | $76.02 | $76.02 | |
CareFirst
| Professional | $100.00 | $100.00 | $133.00 | |
Cigna
| Professional | $63.51 | $63.51 | $63.51 | |
Kaiser Permanente
| Professional | $84.62 | $97.98 | $183.27 | |
United
| Professional | $112.19 | $266.05 | $722.60 |