| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.09 | $16.09 | $16.09 | |
Aetna
| Professional | $16.09 | $16.09 | $21.66 | |
CareFirst
| Professional | $21.00 | $21.00 | $21.00 | |
Cigna
| Professional | $21.88 | $21.88 | $21.88 | |
Kaiser Permanente
| Professional | $25.56 | $25.56 | $78.06 | |
United
| Professional | $13.08 | $19.61 | $30.53 |