| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.59 | $12.59 | $12.59 | |
Aetna
| Professional | $10.72 | $12.02 | $21.38 | |
CareFirst
| Professional | $19.95 | $19.95 | $19.95 | |
Kaiser Permanente
| Professional | $11.22 | $15.85 | $50.12 | |
United
| Professional | $50.12 | $56.23 | $64.57 | |
Wellpoint
| Professional | $12.02 | $12.02 | $12.02 |