| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.57 | $33.57 | $33.57 | |
Aetna
| Professional | $33.57 | $33.57 | $33.57 | |
CareFirst
| Professional | $34.00 | $34.00 | $34.00 | |
Cigna
| Professional | $25.21 | $25.21 | $25.21 | |
Kaiser Permanente
| Professional | $40.94 | $40.94 | $125.03 | |
United
| Professional | $20.95 | $31.42 | $44.51 |