| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.54 | $71.54 | $71.54 | |
Aetna
| Professional | $71.54 | $99.59 | $149.38 | |
CareFirst
| Professional | $83.85 | $83.85 | $83.85 | |
Cigna
| Professional | $60.12 | $60.12 | $60.12 | |
Kaiser Permanente
| Professional | $147.37 | $190.11 | $235.89 | |
United
| Professional | $64.52 | $73.52 | $109.44 | |
Wellpoint
| Professional | $82.10 | $82.10 | $82.10 |