| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.65 | $22.65 | $22.65 | |
Aetna
| Professional | $22.65 | $22.65 | $22.65 | |
CareFirst
| Professional | $30.89 | $30.89 | $30.89 | |
Cigna
| Professional | $24.25 | $24.25 | $24.25 | |
Kaiser Permanente
| Professional | $35.97 | $35.97 | $109.85 | |
United
| Professional | $18.39 | $25.73 | $41.48 |