| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.12 | $12.12 | $12.12 | |
Aetna
| Professional | $12.12 | $16.88 | $23.15 | |
CareFirst
| Professional | $14.21 | $14.21 | $14.21 | |
Cigna
| Professional | $10.19 | $10.19 | $10.19 | |
Kaiser Permanente
| Professional | $24.98 | $32.22 | $39.99 | |
United
| Professional | $10.93 | $12.46 | $19.96 | |
Wellpoint
| Professional | $12.53 | $12.53 | $12.53 |