| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.30 | $60.40 | $71.06 | |
Aetna
| Professional | $11.85 | $61.52 | $76.70 | |
Aetna
| Professional | 25 | $14.48 | $70.06 | $76.20 |
CareFirst
| Professional | $53.03 | $53.03 | $61.63 | |
Kaiser Permanente
| Professional | $79.86 | $79.86 | $167.03 | |
United
| Professional | $50.27 | $79.83 | $164.59 |