| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.52 | $61.52 | $61.52 | |
Aetna
| Professional | $57.90 | $61.52 | $61.52 | |
CareFirst
| Professional | $56.76 | $56.76 | $73.31 | |
Cigna
| Facility | $85.00 | $85.00 | $85.00 | |
Cigna
| Professional | $61.52 | $61.52 | $61.52 | |
Kaiser Permanente
| Professional | $56.20 | $72.52 | $105.49 | |
United
| Professional | $60.32 | $60.32 | $62.13 | |
Wellpoint
| Professional | $94.76 | $94.76 | $94.76 |