| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.95 | $11.95 | $11.95 | |
Aetna
| Professional | $11.95 | $11.95 | $11.95 | |
CareFirst
| Professional | $17.32 | $17.32 | $17.32 | |
Kaiser Permanente
| Professional | $28.25 | $28.25 | $28.25 | |
United
| Professional | $9.65 | $13.44 | $39.28 |