| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.63 | $39.63 | $39.63 | |
Aetna
| Professional | $39.63 | $39.63 | $39.63 | |
CareFirst
| Professional | $43.45 | $43.45 | $43.45 | |
Cigna
| Professional | $37.20 | $37.20 | $37.20 | |
Kaiser Permanente
| Professional | $48.33 | $48.33 | $147.59 | |
United
| Professional | $24.73 | $37.10 | $52.56 |