| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.58 | $10.58 | $20.00 | |
CareFirst
| Professional | $279.05 | $310.05 | $421.67 | |
Cigna
| Professional | $204.44 | $204.44 | $255.54 | |
Kaiser Permanente
| Professional | $633.00 | $633.00 | $1,452.00 | |
Wellpoint
| Professional | $150.00 | $150.00 | $150.00 |