| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $39.81 | $39.81 | $39.81 | |
CareFirst
| Professional | $114.82 | $114.82 | $114.82 | |
Cigna
| Professional | $141.25 | $141.25 | $141.25 | |
Kaiser Permanente
| Professional | $288.40 | $323.59 | $398.11 | |
Wellpoint
| Professional | $218.78 | $218.78 | $218.78 |