| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $112.20 | $128.82 | $218.78 | |
CareFirst
| Professional | $104.71 | $114.82 | $128.82 | |
Cigna
| Professional | $109.65 | $154.88 | $245.47 | |
Kaiser Permanente
| Professional | $109.65 | $128.82 | $181.97 | |
United
| Professional | $104.71 | $147.91 | $245.47 | |
Wellpoint
| Professional | $123.03 | $147.91 | $194.98 |