| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.90 | $30.90 | $60.26 | |
Aetna
| Professional | $17.78 | $30.90 | $48.98 | |
CareFirst
| Professional | $30.90 | $30.90 | $30.90 | |
Cigna
| Professional | $33.88 | $33.88 | $33.88 | |
Kaiser Permanente
| Professional | $36.31 | $36.31 | $48.98 | |
United
| Facility | $33.88 | $33.88 | $33.88 | |
United
| Professional | $33.88 | $36.31 | $39.81 | |
Wellpoint
| Professional | $33.88 | $33.88 | $33.88 |