| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.36 | $22.36 | $22.36 | |
Aetna
| Professional | $22.36 | $22.36 | $22.36 | |
CareFirst
| Professional | $21.05 | $21.05 | $21.05 | |
Cigna
| Facility | $21.05 | $21.05 | $21.05 | |
Kaiser Permanente
| Professional | $49.19 | $49.19 | $49.19 | |
United
| Professional | $19.16 | $21.05 | $34.11 |