| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.20 | $19.20 | $19.20 | |
Aetna
| Professional | $19.19 | $19.20 | $19.20 | |
CareFirst
| Professional | $21.02 | $21.02 | $21.02 | |
Cigna
| Professional | $11.89 | $11.89 | $15.14 | |
Kaiser Permanente
| Professional | $12.20 | $17.57 | $23.17 | |
United
| Professional | $25.48 | $25.74 | $30.89 | |
Wellpoint
| Professional | $18.23 | $18.23 | $18.23 |