| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.46 | $40.46 | $40.46 | |
Aetna
| Professional | $40.46 | $40.46 | $123.66 | |
CareFirst
| Professional | $20.00 | $20.00 | $20.60 | |
Kaiser Permanente
| Professional | $25.93 | $108.63 | $108.63 | |
United
| Professional | $17.52 | $21.81 | $130.72 |