| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
CareFirst
| Professional | $40.00 | $40.00 | $40.00 | |
Cigna
| Professional | $3.60 | $3.60 | $3.60 | |
Kaiser Permanente
| Professional | $50.00 | $57.00 | $69.00 | |
Wellpoint
| Professional | $4.00 | $4.00 | $4.00 |