| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.94 | $26.94 | $26.94 | |
Aetna
| Professional | $26.94 | $26.94 | $27.21 | |
CareFirst
| Professional | $11.64 | $11.64 | $11.64 | |
Cigna
| Facility | $25.42 | $25.42 | $26.94 | |
Cigna
| Professional | $26.94 | $26.94 | $34.32 | |
Kaiser Permanente
| Professional | $22.90 | $22.90 | $107.15 | |
United
| Professional | $26.94 | $26.94 | $43.66 |