| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.03 | $96.26 | $179.87 | |
Aetna
| Professional | $0.03 | $0.03 | $0.04 | |
CareFirst
| Professional | $12.73 | $12.73 | $12.73 | |
Cigna
| Professional | $20.03 | $20.03 | $20.03 | |
Kaiser Permanente
| Professional | $2.00 | $2.00 | $25.00 | |
United
| Professional | $3.54 | $3.54 | $5.15 | |
Wellpoint
| Professional | $1.82 | $5.57 | $5.57 |