| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.20 | $47.20 | $47.20 | |
Aetna
| Professional | $47.20 | $47.20 | $47.20 | |
CareFirst
| Professional | $49.42 | $49.42 | $60.53 | |
Cigna
| Professional | $36.97 | $36.97 | $36.97 | |
Kaiser Permanente
| Professional | $57.56 | $57.56 | $175.77 | |
United
| Professional | $29.45 | $44.17 | $62.58 |