| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31.09 | $31.09 | $31.09 | |
Aetna
| Professional | $31.09 | $31.09 | $31.09 | |
CareFirst
| Professional | $57.99 | $57.99 | $57.99 | |
Cigna
| Professional | $49.06 | $49.06 | $49.06 | |
Kaiser Permanente
| Professional | $42.48 | $42.48 | $128.97 | |
United
| Facility | $149.47 | $149.47 | $149.47 | |
United
| Professional | $34.54 | $51.83 | $77.87 |