| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $65.08 | $65.08 | $65.08 | |
CareFirst
| Professional | $67.44 | $651.55 | $1,041.41 | |
Kaiser Permanente
| Professional | $149.65 | $149.65 | $149.65 | |
United
| Professional | $56.67 | $168.47 | $206.02 |