| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.89 | $26.89 | $26.89 | |
Aetna
| Professional | $26.89 | $26.89 | $26.89 | |
CareFirst
| Professional | $78.40 | $78.40 | $78.40 | |
Cigna
| Professional | $36.27 | $36.27 | $36.27 | |
Kaiser Permanente
| Professional | $38.09 | $38.09 | $120.60 | |
United
| Professional | $24.03 | $40.19 | $64.81 |