| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.22 | $15.58 | $15.58 | |
Aetna
| Professional | $16.07 | $16.07 | $20.88 | |
CareFirst
| Professional | $57.60 | $57.60 | $57.60 | |
Cigna
| Professional | $16.07 | $16.07 | $20.48 | |
Kaiser Permanente
| Professional | $16.07 | $16.07 | $76.73 | |
United
| Professional | $16.07 | $16.07 | $17.04 | |
Wellpoint
| Professional | $38.28 | $38.28 | $38.28 |