| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.97 | $22.97 | $22.97 | |
Aetna
| Professional | $22.97 | $22.97 | $22.97 | |
CareFirst
| Professional | $21.62 | $21.62 | $21.62 | |
Cigna
| Facility | $22.97 | $22.97 | $22.97 | |
Kaiser Permanente
| Professional | $33.32 | $33.32 | $33.32 | |
United
| Professional | $20.49 | $22.52 | $36.50 |