| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $132.88 | $132.88 | $132.88 | |
CareFirst
| Professional | $292.50 | $325.00 | $442.00 | |
Kaiser Permanente
| Professional | $255.00 | $423.00 | $423.00 | |
Wellpoint
| Professional | $150.00 | $150.00 | $150.00 |