| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.61 | $25.61 | $25.61 | |
Aetna
| Professional | $25.61 | $25.61 | $25.61 | |
CareFirst
| Professional | $34.00 | $34.00 | $34.00 | |
Cigna
| Professional | $23.30 | $23.30 | $23.30 | |
Kaiser Permanente
| Professional | $40.67 | $40.67 | $124.20 | |
United
| Professional | $20.81 | $29.09 | $58.43 |