| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.22 | $54.18 | $237.78 | |
Aetna
| Facility | CQ | $55.68 | $117.11 | $476.79 |
Aetna
| Professional | $13.00 | $20.26 | $21.10 | |
CareFirst
| Professional | $21.69 | $21.69 | $105.60 | |
Cigna
| Professional | $28.00 | $81.30 | $116.06 | |
Kaiser Permanente
| Professional | $28.56 | $30.50 | $30.50 | |
United
| Professional | $21.20 | $32.61 | $63.66 |