| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.60 | $252.57 | $431.80 | |
Aetna
| Professional | $30.60 | $30.60 | $30.60 | |
CareFirst
| Professional | $28.80 | $28.80 | $28.80 | |
Cigna
| Facility | $30.60 | $30.60 | $30.60 | |
Cigna
| Professional | $30.60 | $30.60 | $30.60 | |
Kaiser Permanente
| Professional | $29.07 | $29.07 | $38.60 | |
United
| Professional | $30.00 | $30.00 | $48.62 |