| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.50 | $15.50 | $15.50 | |
Aetna
| Professional | $15.50 | $15.50 | $16.13 | |
CareFirst
| Professional | $36.00 | $36.00 | $36.00 | |
Kaiser Permanente
| Professional | $17.63 | $38.99 | $38.99 |