| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.88 | $21.88 | $21.88 | |
Aetna
| Professional | $21.88 | $25.12 | $69.18 | |
CareFirst
| Professional | $30.90 | $30.90 | $38.90 | |
Cigna
| Facility | $31.62 | $31.62 | $31.62 | |
Cigna
| Professional | $22.91 | $22.91 | $33.88 | |
Kaiser Permanente
| Professional | $36.31 | $79.43 | $109.65 | |
United
| Facility | $83.18 | $83.18 | $83.18 | |
United
| Professional | $18.20 | $27.54 | $51.29 |