| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.66 | $30.66 | $30.66 | |
Aetna
| Professional | $30.66 | $30.66 | $39.27 | |
CareFirst
| Professional | $40.00 | $40.00 | $51.21 | |
Cigna
| Professional | $34.09 | $34.09 | $34.09 | |
Kaiser Permanente
| Professional | $48.69 | $48.69 | $148.69 | |
United
| Facility | $104.62 | $104.62 | $104.62 | |
United
| Professional | $24.92 | $33.74 | $56.15 |