| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.24 | $39.24 | $39.24 | |
Aetna
| Professional | $39.24 | $39.24 | $39.24 | |
CareFirst
| Professional | $92.00 | $92.00 | $100.28 | |
Kaiser Permanente
| Professional | $45.51 | $98.67 | $98.67 |