| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.48 | $30.48 | $30.48 | |
Aetna
| Professional | $30.48 | $30.48 | $30.48 | |
CareFirst
| Professional | $40.00 | $40.00 | $40.00 | |
Cigna
| Professional | $29.76 | $29.76 | $29.76 | |
Kaiser Permanente
| Professional | $48.41 | $48.41 | $147.82 | |
United
| Professional | $24.77 | $37.15 | $55.83 |