| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.14 | $30.14 | $30.14 | |
Aetna
| Professional | $30.14 | $30.14 | $30.14 | |
CareFirst
| Professional | $39.00 | $39.00 | $39.00 | |
Cigna
| Professional | $33.90 | $33.90 | $33.90 | |
Kaiser Permanente
| Professional | $47.87 | $47.87 | $146.16 | |
United
| Professional | $24.49 | $36.74 | $55.20 |