| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.68 | $12.68 | $12.68 | |
Aetna
| Professional | $12.68 | $12.68 | $12.68 | |
CareFirst
| Professional | $19.75 | $19.75 | $19.75 | |
Cigna
| Facility | $11.97 | $11.97 | $11.97 | |
Kaiser Permanente
| Professional | $24.60 | $24.60 | $24.60 | |
United
| Professional | $50.95 | $51.46 | $66.98 |