| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.01 | $28.01 | $28.01 | |
Aetna
| Professional | $28.01 | $28.01 | $28.01 | |
CareFirst
| Professional | $37.00 | $37.00 | $37.00 | |
Cigna
| Professional | $31.22 | $31.22 | $31.22 | |
Kaiser Permanente
| Professional | $44.49 | $44.49 | $135.88 | |
United
| Professional | $22.77 | $34.15 | $51.31 |