| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.34 | $25.34 | $25.34 | |
Aetna
| Professional | $12.60 | $16.28 | $25.34 | |
CareFirst
| Professional | $20.00 | $20.00 | $20.00 | |
Cigna
| Professional | $12.80 | $12.80 | $12.80 | |
Kaiser Permanente
| Professional | $10.09 | $12.42 | $30.23 | |
United
| Professional | $12.15 | $29.58 | $56.00 |