| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.52 | $34.52 | $34.52 | |
Aetna
| Professional | $34.52 | $34.52 | $34.52 | |
CareFirst
| Professional | $23.58 | $23.58 | $23.58 | |
Kaiser Permanente
| Professional | $36.27 | $36.27 | $72.00 | |
United
| Professional | $12.06 | $19.48 | $88.69 |