| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $35.25 | $35.25 | $35.25 | |
Aetna
| Professional | $35.25 | $35.25 | $35.25 | |
CareFirst
| Professional | $35.28 | $35.28 | $35.65 | |
Cigna
| Professional | $21.28 | $21.28 | $29.28 | |
Kaiser Permanente
| Professional | $103.55 | $103.55 | $103.55 | |
United
| Professional | $17.35 | $23.50 | $36.86 |