| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $60.52 | $60.52 | $60.52 | |
Aetna
| Professional | $60.52 | $60.52 | $60.52 | |
CareFirst
| Professional | $82.00 | $109.00 | $118.81 | |
Kaiser Permanente
| Professional | $69.98 | $151.58 | $151.58 |