| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.04 | $15.04 | $15.04 | |
Aetna
| Professional | $15.04 | $15.04 | $15.04 | |
CareFirst
| Professional | $52.05 | $52.05 | $52.05 | |
Cigna
| Professional | $20.86 | $20.86 | $20.86 | |
Kaiser Permanente
| Professional | $21.30 | $21.30 | $67.44 | |
United
| Professional | $13.44 | $22.48 | $33.77 |