| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $487.50 | $562.50 | $562.50 | |
CareFirst
| Professional | $600.00 | $600.00 | $684.00 | |
Kaiser Permanente
| Professional | $750.00 | $900.00 | $1,125.00 | |
United
| Professional | $315.00 | $345.00 | $655.62 | |
Wellpoint
| Professional | $375.00 | $375.00 | $375.00 |