| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.58 | $20.58 | $20.58 | |
Aetna
| Professional | $20.58 | $20.58 | $20.58 | |
CareFirst
| Professional | $29.93 | $29.93 | $29.93 | |
Kaiser Permanente
| Professional | $48.95 | $48.95 | $48.95 | |
United
| Professional | $16.89 | $24.28 | $68.06 |