| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.90 | $22.90 | $22.90 | |
Aetna
| Professional | $22.90 | $31.88 | $47.82 | |
CareFirst
| Professional | $26.86 | $26.86 | $26.86 | |
Cigna
| Professional | $19.25 | $19.25 | $19.25 | |
Kaiser Permanente
| Professional | $47.18 | $60.86 | $75.52 | |
United
| Professional | $20.66 | $23.54 | $34.07 | |
Wellpoint
| Professional | $38.69 | $38.69 | $38.69 |