| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.77 | $30.77 | $30.77 | |
Aetna
| Professional | $25.46 | $25.46 | $39.39 | |
CareFirst
| Professional | $25.46 | $25.46 | $30.77 | |
Cigna
| Professional | $25.46 | $25.46 | $32.42 | |
Kaiser Permanente
| Professional | $25.46 | $25.46 | $39.43 | |
United
| Professional | $25.46 | $25.46 | $28.92 | |
Wellpoint
| Professional | $32.86 | $32.86 | $32.86 |