| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $450.67 | $519.54 | $1,500.00 | |
CareFirst
| Professional | $595.35 | $668.84 | $999.60 | |
Cigna
| Professional | $109.45 | $109.45 | $136.81 | |
Kaiser Permanente
| Professional | $1,240.00 | $1,738.00 | $1,738.00 | |
Wellpoint
| Professional | $900.00 | $900.00 | $900.00 |