| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.49 | $4.49 | $4.49 | |
Aetna
| Professional | $3.91 | $3.91 | $5.75 | |
CareFirst
| Professional | $3.91 | $3.91 | $4.48 | |
Cigna
| Professional | $3.91 | $3.91 | $4.98 | |
Kaiser Permanente
| Professional | $3.91 | $3.91 | $16.20 | |
United
| Professional | $3.91 | $3.91 | $4.13 | |
Wellpoint
| Professional | $3.90 | $3.90 | $3.90 |