| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.39 | $22.39 | $22.39 | |
Aetna
| Professional | $20.89 | $21.88 | $35.48 | |
CareFirst
| Professional | $20.89 | $20.89 | $20.89 | |
Cigna
| Professional | $20.89 | $20.89 | $26.92 | |
Kaiser Permanente
| Professional | $22.39 | $25.70 | $46.77 | |
United
| Professional | $20.89 | $20.89 | $25.12 |