| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $189.48 | $189.48 | $189.48 | |
CareFirst
| Professional | $317.14 | $317.14 | $317.14 | |
Kaiser Permanente
| Professional | $208.57 | $208.57 | $208.57 | |
United
| Professional | $121.78 | $182.68 | $182.68 |