| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.33 | $11.33 | $11.33 | |
Aetna
| Professional | $11.33 | $11.33 | $11.33 | |
CareFirst
| Professional | $15.45 | $15.45 | $18.91 | |
Cigna
| Professional | $11.53 | $11.53 | $11.53 | |
Kaiser Permanente
| Professional | $17.98 | $17.98 | $54.92 | |
United
| Professional | $9.19 | $13.80 | $21.49 |