| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.94 | $39.94 | $39.94 | |
Aetna
| Professional | $39.94 | $39.94 | $39.94 | |
CareFirst
| Professional | $52.00 | $52.00 | $52.00 | |
Cigna
| Professional | $45.85 | $45.85 | $45.85 | |
Kaiser Permanente
| Professional | $63.43 | $63.43 | $193.70 | |
United
| Professional | $32.46 | $48.68 | $73.15 |