| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.12 | $25.12 | $25.12 | |
Aetna
| Professional | $23.99 | $23.99 | $42.66 | |
CareFirst
| Professional | $29.51 | $29.51 | $29.51 | |
Kaiser Permanente
| Professional | $25.70 | $29.51 | $45.71 | |
United
| Professional | $29.51 | $29.51 | $33.88 |