| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.11 | $25.11 | $25.11 | |
Aetna
| Professional | $25.11 | $25.11 | $25.11 | |
CareFirst
| Professional | $29.00 | $48.94 | $65.09 | |
Cigna
| Professional | $27.99 | $54.79 | $185.04 | |
Kaiser Permanente
| Professional | $58.95 | $58.95 | $58.95 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 | |
United
| Professional | $33.34 | $52.96 | $100.67 |