| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.63 | $40.63 | $40.63 | |
Aetna
| Professional | $40.63 | $40.63 | $40.63 | |
CareFirst
| Professional | $42.55 | $42.55 | $52.11 | |
Cigna
| Professional | $52.71 | $52.71 | $52.71 | |
Kaiser Permanente
| Professional | $49.55 | $49.55 | $151.31 | |
United
| Professional | $25.35 | $38.02 | $65.00 |