| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.92 | $19.92 | $19.92 | |
Aetna
| Professional | $19.92 | $19.92 | $19.92 | |
CareFirst
| Professional | $26.00 | $26.00 | $33.26 | |
Cigna
| Professional | $21.64 | $21.64 | $21.64 | |
Kaiser Permanente
| Professional | $31.63 | $31.63 | $96.59 | |
United
| Professional | $16.18 | $24.28 | $36.47 |