| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.65 | $47.65 | $47.65 | |
Aetna
| Professional | $47.65 | $47.65 | $47.65 | |
CareFirst
| Professional | $62.00 | $62.00 | $79.58 | |
Cigna
| Professional | $53.49 | $53.49 | $53.49 | |
Kaiser Permanente
| Professional | $75.67 | $75.67 | $231.10 | |
United
| Professional | $38.72 | $58.08 | $87.27 |