| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.07 | $66.07 | $177.83 | |
Aetna
| Professional | $63.10 | $70.79 | $213.80 | |
CareFirst
| Professional | $74.13 | $74.13 | $74.13 | |
Cigna
| Professional | $70.79 | $70.79 | $70.79 | |
Kaiser Permanente
| Professional | $70.79 | $70.79 | $70.79 | |
United
| Facility | $66.07 | $66.07 | $66.07 | |
United
| Professional | $63.10 | $74.13 | $79.43 | |
Wellpoint
| Professional | $61.66 | $61.66 | $61.66 |