| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $28.36 | $28.36 | $28.36 | |
CareFirst
| Professional | $15.69 | $15.69 | $15.69 | |
Cigna
| Facility | $12.60 | $12.60 | $12.60 | |
Cigna
| Professional | $10.71 | $10.71 | $12.60 | |
Kaiser Permanente
| Professional | $23.54 | $23.54 | $23.54 | |
United
| Professional | $13.25 | $14.35 | $22.08 | |
Wellpoint
| Professional | $25.00 | $25.00 | $25.00 |