| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.06 | $23.06 | $23.06 | |
Aetna
| Professional | $15.17 | $32.11 | $107.00 | |
CareFirst
| Professional | $27.03 | $27.03 | $27.03 | |
Cigna
| Professional | $19.38 | $19.38 | $19.38 | |
Kaiser Permanente
| Professional | $47.51 | $61.29 | $76.05 | |
United
| Professional | $20.80 | $23.70 | $35.90 | |
Wellpoint
| Professional | $20.32 | $20.32 | $20.32 |