| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.99 | $24.99 | $24.99 | |
Aetna
| Professional | $24.39 | $24.99 | $31.99 | |
CareFirst
| Professional | $24.50 | $24.50 | $24.50 | |
Cigna
| Professional | $24.50 | $24.50 | $31.20 | |
United
| Professional | $29.40 | $29.40 | $42.41 |