| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.81 | $2.81 | $2.81 | |
Aetna
| Professional | $2.81 | $2.81 | $2.81 | |
CareFirst
| Professional | $55.50 | $55.50 | $55.50 | |
Cigna
| Professional | $99.00 | $99.00 | $99.00 | |
Kaiser Permanente
| Professional | $568.00 | $568.00 | $568.00 |