| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4.00 | $4.00 | $4.00 | |
CareFirst
| Professional | $3.70 | $3.70 | $3.70 | |
Cigna
| Professional | $1.76 | $1.76 | $1.76 | |
Kaiser Permanente
| Professional | $4.00 | $4.00 | $5.00 | |
Wellpoint
| Professional | $2.29 | $2.29 | $2.29 |