| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.00 | $3.00 | $3.00 | |
Aetna
| Professional | $3.00 | $3.00 | $3.00 | |
CareFirst
| Professional | $16.92 | $16.92 | $16.92 | |
Kaiser Permanente
| Professional | $38.76 | $38.76 | $38.76 | |
United
| Professional | $11.12 | $16.59 | $50.47 |