| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.67 | $30.67 | $30.67 | |
Aetna
| Professional | $30.67 | $30.67 | $30.67 | |
CareFirst
| Professional | $40.00 | $40.00 | $51.23 | |
Cigna
| Professional | $40.76 | $40.76 | $40.76 | |
Kaiser Permanente
| Professional | $48.71 | $48.71 | $148.75 | |
United
| Professional | $24.93 | $36.61 | $58.19 |