| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.58 | $25.58 | $25.58 | |
Aetna
| Professional | $25.58 | $25.58 | $61.90 | |
CareFirst
| Professional | $50.22 | $57.73 | $57.73 | |
Cigna
| Professional | $44.34 | $44.34 | $44.34 | |
Kaiser Permanente
| Professional | $33.61 | $33.61 | $102.08 | |
United
| Professional | $30.48 | $43.04 | $53.96 |