| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.70 | $20.70 | $20.70 | |
Aetna
| Professional | $20.70 | $28.81 | $97.00 | |
CareFirst
| Professional | $24.25 | $24.25 | $24.25 | |
Cigna
| Professional | $17.39 | $17.39 | $17.39 | |
Kaiser Permanente
| Professional | $42.64 | $55.01 | $68.25 | |
United
| Professional | $18.67 | $21.27 | $31.67 | |
Wellpoint
| Professional | $26.44 | $26.44 | $26.44 |