| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.99 | $50.99 | $50.99 | |
CareFirst
| Professional | $86.66 | $86.66 | $86.66 | |
Kaiser Permanente
| Professional | $57.27 | $57.27 | $57.27 | |
United
| Professional | $32.77 | $49.15 | $49.15 |