| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.22 | $34.22 | $34.22 | |
Aetna
| Professional | $34.22 | $34.22 | $34.22 | |
CareFirst
| Professional | $23.67 | $23.67 | $23.67 | |
Kaiser Permanente
| Professional | $35.96 | $35.96 | $71.39 | |
United
| Professional | $11.96 | $19.97 | $87.94 |