| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.61 | $67.61 | $67.61 | |
Aetna
| Professional | $61.66 | $67.61 | $102.33 | |
CareFirst
| Professional | $134.90 | $134.90 | $181.97 | |
Kaiser Permanente
| Professional | $81.28 | $85.11 | $173.78 |