| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.56 | $77.06 | $273.43 | |
Aetna
| Facility | CQ | $42.28 | $91.81 | $737.37 |
Aetna
| Professional | $12.00 | $22.98 | $22.98 | |
CareFirst
| Professional | $23.24 | $23.24 | $115.20 | |
Cigna
| Professional | $29.09 | $81.06 | $116.06 | |
Kaiser Permanente
| Professional | $30.26 | $32.34 | $32.34 | |
United
| Professional | $22.75 | $35.58 | $72.98 |