| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.46 | $25.46 | $25.46 | |
Aetna
| Professional | $25.46 | $25.46 | $25.46 | |
CareFirst
| Professional | $33.00 | $33.00 | $33.00 | |
Cigna
| Professional | $35.76 | $35.76 | $35.76 | |
Kaiser Permanente
| Professional | $40.43 | $40.43 | $123.47 | |
United
| Professional | $20.69 | $31.03 | $48.30 |