| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $217.46 | $217.46 | $217.46 | |
CareFirst
| Professional | $49.72 | $55.24 | $75.13 | |
Kaiser Permanente
| Professional | $390.00 | $647.00 | $647.00 | |
Wellpoint
| Professional | $225.00 | $225.00 | $225.00 |