| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.12 | $25.12 | $25.12 | |
Aetna
| Professional | $25.12 | $42.66 | $234.42 | |
CareFirst
| Professional | $28.84 | $47.86 | $104.71 | |
Cigna
| Professional | $28.84 | $54.95 | $186.21 | |
Kaiser Permanente
| Professional | $58.88 | $58.88 | $91.20 | |
United
| Facility | $165.96 | $549.54 | $5,888.44 | |
United
| Professional | $39.81 | $53.70 | $100.00 |