| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.86 | $39.86 | $39.86 | |
Aetna
| Professional | $39.86 | $39.86 | $39.86 | |
CareFirst
| Professional | $52.00 | $52.00 | $52.00 | |
Cigna
| Professional | $61.31 | $61.31 | $61.31 | |
Kaiser Permanente
| Professional | $63.30 | $63.30 | $193.31 | |
United
| Professional | $32.39 | $48.58 | $102.19 |