| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.55 | $28.55 | $28.55 | |
Aetna
| Professional | $28.55 | $28.55 | $28.55 | |
CareFirst
| Professional | $37.00 | $37.00 | $37.00 | |
Cigna
| Professional | $31.81 | $31.81 | $31.81 | |
Kaiser Permanente
| Professional | $45.34 | $45.34 | $138.47 | |
United
| Professional | $23.20 | $34.79 | $65.15 |