| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.60 | $54.11 | $712.74 | |
Aetna
| Professional | $11.59 | $26.26 | $119.65 | |
CareFirst
| Professional | $19.32 | $21.48 | $27.28 | |
Cigna
| Professional | $15.20 | $29.42 | $85.75 | |
Kaiser Permanente
| Professional | $39.24 | $53.08 | $98.88 | |
United
| Facility | $150.00 | $150.00 | $150.00 | |
United
| Professional | $28.37 | $50.98 | $66.06 | |
Wellpoint
| Professional | $25.54 | $25.68 | $53.08 |