| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.07 | $18.07 | $18.07 | |
Aetna
| Professional | $18.07 | $18.07 | $18.07 | |
CareFirst
| Professional | $36.15 | $36.15 | $36.15 | |
Cigna
| Professional | $32.43 | $32.43 | $32.43 | |
Kaiser Permanente
| Professional | $23.76 | $23.76 | $72.16 | |
United
| Facility | $77.73 | $77.73 | $77.73 | |
United
| Professional | $21.54 | $29.17 | $38.15 |