| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.92 | $21.92 | $21.92 | |
Aetna
| Professional | $21.92 | $21.92 | $21.92 | |
CareFirst
| Professional | $29.00 | $29.00 | $36.61 | |
Cigna
| Professional | $28.59 | $28.59 | $28.59 | |
Kaiser Permanente
| Professional | $34.81 | $34.81 | $106.31 | |
United
| Professional | $17.82 | $26.72 | $40.15 |