| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.00 | $2.00 | $2.00 | |
Aetna
| Professional | $2.00 | $2.00 | $2.00 | |
CareFirst
| Professional | $54.95 | $54.95 | $54.95 | |
Cigna
| Professional | $100.00 | $100.00 | $371.54 | |
Kaiser Permanente
| Professional | $562.34 | $562.34 | $562.34 |