| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.62 | $77.62 | $77.62 | |
Aetna
| Professional | $57.54 | $67.61 | $77.62 | |
CareFirst
| Professional | $66.07 | $74.13 | $97.72 | |
Kaiser Permanente
| Professional | $169.82 | $169.82 | $169.82 | |
United
| Facility | $181.97 | $1,318.26 | $6,309.57 | |
United
| Professional | $54.95 | $81.28 | $154.88 |