| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.02 | $2.02 | $2.02 | |
Aetna
| Professional | $2.02 | $2.02 | $2.02 | |
CareFirst
| Professional | $106.10 | $106.10 | $106.10 | |
Cigna
| Professional | $93.87 | $93.87 | $93.87 | |
Kaiser Permanente
| Professional | $152.00 | $152.00 | $152.00 |