| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.50 | $19.50 | $19.50 | |
Aetna
| Professional | $19.05 | $19.05 | $33.11 | |
CareFirst
| Professional | $22.91 | $22.91 | $22.91 | |
Cigna
| Professional | $21.38 | $21.38 | $21.38 | |
Kaiser Permanente
| Professional | $33.11 | $33.11 | $35.48 | |
United
| Professional | $22.91 | $22.91 | $26.30 | |
Wellpoint
| Professional | $21.88 | $21.88 | $21.88 |