| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.91 | $29.91 | $29.91 | |
Aetna
| Professional | $29.91 | $29.91 | $29.91 | |
CareFirst
| Professional | $31.21 | $31.21 | $31.21 | |
Cigna
| Facility | $28.22 | $28.22 | $29.91 | |
Cigna
| Professional | $29.91 | $29.91 | $38.10 | |
Kaiser Permanente
| Professional | $25.42 | $25.42 | $34.79 | |
United
| Professional | $29.91 | $29.91 | $48.48 |