| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.97 | $28.97 | $28.97 | |
Aetna
| Professional | $28.97 | $28.97 | $28.97 | |
CareFirst
| Professional | $28.97 | $50.39 | $85.21 | |
Cigna
| Facility | $31.94 | $31.94 | $31.94 | |
Kaiser Permanente
| Professional | $65.80 | $65.80 | $65.80 | |
United
| Professional | $32.06 | $34.08 | $42.15 |