| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.29 | $15.29 | $15.29 | |
Aetna
| Professional | $15.29 | $15.29 | $15.29 | |
CareFirst
| Professional | $20.00 | $20.00 | $20.00 | |
Cigna
| Professional | $15.61 | $15.61 | $15.61 | |
Kaiser Permanente
| Professional | $24.28 | $24.28 | $74.15 | |
United
| Professional | $12.42 | $18.64 | $34.89 |