| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $110.46 | $110.46 | $110.46 | |
Aetna
| Professional | $52.85 | $57.50 | $63.19 | |
CareFirst
| Professional | $82.00 | $109.00 | $124.59 | |
Kaiser Permanente
| Professional | $70.19 | $90.55 | $138.60 |