| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.24 | $2.24 | $2.24 | |
Aetna
| Professional | $112.28 | $212.16 | $700.00 | |
CareFirst
| Professional | $282.88 | $311.17 | $710.74 | |
Cigna
| Professional | $149.93 | $201.13 | $1,077.05 | |
Kaiser Permanente
| Professional | $282.88 | $339.46 | $424.32 | |
United
| Professional | $118.81 | $141.44 | $247.28 | |
Wellpoint
| Professional | $141.44 | $141.44 | $141.44 |