| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $104.98 | $104.98 | $104.98 | |
CareFirst
| Professional | $125.20 | $125.20 | $139.62 | |
Kaiser Permanente
| Professional | $132.76 | $132.76 | $132.76 | |
United
| Professional | $67.67 | $101.90 | $101.90 |