| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5.00 | $5.00 | $5.00 | |
Aetna
| Professional | $5.00 | $5.00 | $5.00 | |
CareFirst
| Professional | $7.72 | $7.72 | $7.72 | |
Kaiser Permanente
| Professional | $19.30 | $19.30 | $19.30 | |
United
| Professional | $11.12 | $14.96 | $25.14 |