| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.05 | $19.05 | $19.05 | |
Aetna
| Professional | $16.98 | $19.95 | $30.90 | |
CareFirst
| Professional | $21.38 | $23.44 | $30.90 | |
Cigna
| Professional | $17.78 | $24.55 | $66.07 | |
Kaiser Permanente
| Professional | $23.99 | $25.70 | $30.90 | |
United
| Facility | $16.98 | $645.65 | $741.31 | |
United
| Professional | $16.60 | $23.44 | $45.71 |