| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $119.74 | $119.74 | $119.74 | |
CareFirst
| Professional | $170.46 | $170.46 | $170.46 | |
Kaiser Permanente
| Professional | $187.71 | $187.71 | $187.71 | |
United
| Professional | $85.20 | $142.51 | $142.51 |