| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.95 | $30.95 | $30.95 | |
Aetna
| Professional | $30.95 | $30.95 | $30.95 | |
CareFirst
| Professional | $41.00 | $41.00 | $51.69 | |
Cigna
| Professional | $47.60 | $47.60 | $47.60 | |
Kaiser Permanente
| Professional | $49.15 | $49.15 | $150.09 | |
United
| Professional | $25.15 | $37.72 | $56.68 |