| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.17 | $72.17 | $72.17 | |
Aetna
| Professional | $30.00 | $30.00 | $44.00 | |
CareFirst
| Professional | $39.00 | $39.00 | $39.00 | |
Cigna
| Professional | $14.68 | $14.68 | $14.68 | |
Kaiser Permanente
| Professional | $38.04 | $47.55 | $57.06 | |
United
| Professional | $22.16 | $22.16 | $35.45 | |
Wellpoint
| Professional | $32.33 | $40.00 | $40.00 |