| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.98 | $29.98 | $29.98 | |
Aetna
| Professional | $29.98 | $29.98 | $29.98 | |
CareFirst
| Professional | $25.25 | $25.25 | $30.32 | |
Cigna
| Professional | $22.66 | $22.66 | $22.66 | |
Kaiser Permanente
| Professional | $88.06 | $88.06 | $88.06 | |
United
| Professional | $14.76 | $22.13 | $36.64 |