| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $8.00 | $8.00 | $8.00 | |
CareFirst
| Professional | $8.00 | $8.00 | $8.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $9.24 | $9.24 | $10.84 | |
Kaiser Permanente
| Professional | $95.00 | $95.00 | $130.00 |