| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.88 | $38.02 | $48.98 | |
Aetna
| Professional | $1.15 | $12.88 | $12.88 | |
CareFirst
| Professional | $22.39 | $26.30 | $54.95 | |
Cigna
| Facility | $12.30 | $12.88 | $12.88 | |
Kaiser Permanente
| Professional | $10.96 | $10.96 | $12.88 | |
United
| Professional | $12.88 | $12.88 | $20.89 |