| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.87 | $46.87 | $46.87 | |
Aetna
| Professional | $46.87 | $46.87 | $46.87 | |
CareFirst
| Professional | $43.38 | $43.38 | $43.38 | |
Cigna
| Facility | $46.87 | $46.87 | $46.87 | |
Kaiser Permanente
| Professional | $23.80 | $23.80 | $23.80 | |
United
| Professional | $41.81 | $45.95 | $74.47 |