| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.20 | $33.20 | $33.20 | |
Aetna
| Professional | $33.20 | $33.20 | $33.20 | |
CareFirst
| Professional | $30.32 | $30.32 | $30.32 | |
Kaiser Permanente
| Professional | $31.47 | $31.47 | $62.10 | |
United
| Professional | $11.52 | $28.67 | $76.50 |