| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.69 | $30.69 | $30.69 | |
Aetna
| Professional | $30.69 | $30.69 | $30.69 | |
CareFirst
| Professional | $41.40 | $41.40 | $45.13 | |
Kaiser Permanente
| Professional | $35.70 | $76.55 | $76.55 |