| 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 | $26.92 | |
CareFirst
| Professional | $21.62 | $21.62 | $21.62 | |
Cigna
| Professional | $22.97 | $22.97 | $22.97 | |
Kaiser Permanente
| Professional | $14.65 | $17.00 | $21.97 | |
United
| Professional | $22.52 | $22.52 | $27.01 |