| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $37.50 | $37.50 | $37.50 | |
Aetna
| Professional | $37.50 | $37.50 | $37.50 | |
CareFirst
| Professional | $33.71 | $33.71 | $33.71 | |
Kaiser Permanente
| Professional | $37.54 | $37.54 | $74.11 | |
United
| Facility | $54.89 | $54.89 | $54.89 | |
United
| Professional | $13.01 | $25.57 | $91.29 |