| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $299.83 | $299.83 | $299.83 | |
CareFirst
| Professional | $38.07 | $42.70 | $63.92 | |
Cigna
| Professional | $109.45 | $109.45 | $136.81 | |
Kaiser Permanente
| Professional | $505.00 | $838.00 | $838.00 | |
Wellpoint
| Professional | $108.00 | $424.00 | $424.00 |