| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.96 | $139.99 | $578.25 | |
Aetna
| Professional | $9.61 | $9.61 | $9.61 | |
CareFirst
| Professional | $21.75 | $21.75 | $21.75 | |
Kaiser Permanente
| Professional | $22.18 | $22.18 | $22.18 | |
United
| Professional | $11.00 | $13.16 | $32.46 |