| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.52 | $17.52 | $17.52 | |
Aetna
| Professional | $17.52 | $24.40 | $76.00 | |
CareFirst
| Professional | $20.53 | $20.53 | $20.53 | |
Cigna
| Professional | $14.73 | $14.73 | $14.73 | |
Kaiser Permanente
| Professional | $36.10 | $46.57 | $57.79 | |
United
| Professional | $15.80 | $18.01 | $27.29 | |
Wellpoint
| Professional | $18.92 | $18.92 | $18.92 |