| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.00 | $110.20 | $126.71 | |
CareFirst
| Professional | $38.07 | $42.70 | $63.92 | |
Cigna
| Facility | $85.64 | $91.05 | $168.62 | |
Cigna
| Professional | $62.78 | $62.78 | $78.47 | |
Kaiser Permanente
| Professional | $176.00 | $229.00 | $229.00 | |
Wellpoint
| Professional | $32.40 | $32.40 | $32.40 |