| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.29 | $51.29 | $51.29 | |
Aetna
| Professional | $51.29 | $79.43 | $107.15 | |
CareFirst
| Professional | $117.49 | $117.49 | $117.49 | |
Kaiser Permanente
| Professional | $91.20 | $91.20 | $177.83 | |
United
| Professional | $37.15 | $61.66 | $125.89 |