| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.62 | $18.62 | $18.62 | |
Aetna
| Professional | $18.62 | $18.62 | $18.62 | |
CareFirst
| Professional | $16.32 | $16.32 | $16.32 | |
Cigna
| Professional | $17.52 | $17.52 | $17.52 | |
Kaiser Permanente
| Professional | $12.90 | $14.98 | $19.35 | |
United
| Professional | $18.62 | $18.62 | $21.04 | |
Wellpoint
| Professional | $16.28 | $16.28 | $16.28 |