| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $199.28 | $199.28 | $199.28 | |
CareFirst
| Professional | $237.65 | $237.65 | $265.05 | |
Kaiser Permanente
| Professional | $252.02 | $252.02 | $252.02 | |
United
| Professional | $128.96 | $193.43 | $193.43 |