| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.31 | $32.08 | $37.75 | |
Aetna
| Professional | $7.69 | $37.61 | $45.46 | |
Aetna
| Professional | 25 | $7.82 | $7.82 | $7.82 |
CareFirst
| Professional | $34.26 | $34.26 | $34.26 | |
Kaiser Permanente
| Professional | $42.80 | $42.80 | $90.31 | |
United
| Professional | $31.10 | $88.85 | $88.99 |