| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.79 | $70.79 | $70.79 | |
Aetna
| Professional | $70.79 | $70.79 | $123.03 | |
CareFirst
| Professional | $125.89 | $141.25 | $165.96 | |
Kaiser Permanente
| Professional | $51.29 | $54.95 | $112.20 |