| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.10 | $13.10 | $13.10 | |
Aetna
| Professional | $13.10 | $13.10 | $13.10 | |
CareFirst
| Professional | $13.00 | $13.00 | $16.80 | |
Cigna
| Professional | $11.89 | $11.89 | $11.89 | |
Kaiser Permanente
| Professional | $15.98 | $15.98 | $48.81 | |
United
| Facility | $37.34 | $37.34 | $37.34 | |
United
| Professional | $8.18 | $12.27 | $17.38 |