| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $32.00 | $32.00 | $32.00 | |
Aetna
| Professional | $32.00 | $32.00 | $32.00 | |
CareFirst
| Professional | $30.00 | $30.00 | $30.00 | |
Cigna
| Professional | $17.20 | $17.20 | $17.20 | |
Kaiser Permanente
| Professional | $76.00 | $76.00 | $76.00 |