| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.87 | $46.87 | $46.87 | |
Aetna
| Professional | $46.87 | $46.87 | $59.99 | |
CareFirst
| Professional | $43.38 | $43.38 | $43.38 | |
Cigna
| Professional | $46.87 | $46.87 | $46.87 | |
Kaiser Permanente
| Professional | $10.46 | $12.15 | $15.69 | |
United
| Professional | $45.95 | $45.95 | $55.14 | |
Wellpoint
| Professional | $30.99 | $30.99 | $30.99 |