| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.65 | $22.65 | $59.97 | |
Aetna
| Professional | $22.65 | $33.20 | $59.97 | |
CareFirst
| Professional | $26.28 | $26.28 | $26.28 | |
Cigna
| Professional | $25.87 | $76.72 | $203.12 | |
Kaiser Permanente
| Professional | $61.70 | $142.16 | $142.16 | |
United
| Professional | $62.67 | $141.21 | $212.18 |