| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $174.83 | $174.83 | $174.83 | |
CareFirst
| Professional | $329.00 | $329.00 | $353.76 | |
Kaiser Permanente
| Professional | $364.65 | $364.65 | $364.65 | |
United
| Professional | $124.40 | $208.07 | $208.07 |