| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.03 | $17.03 | $17.03 | |
Aetna
| Professional | $17.03 | $17.03 | $21.80 | |
CareFirst
| Professional | $17.03 | $17.03 | $17.03 | |
Cigna
| Professional | $16.98 | $16.98 | $21.64 | |
Kaiser Permanente
| Professional | $5.00 | $5.00 | $5.00 | |
United
| Professional | $20.04 | $20.04 | $20.54 |