| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $105.88 | $105.88 | $105.88 | |
CareFirst
| Professional | $182.07 | $182.07 | $197.97 | |
Kaiser Permanente
| Professional | $110.82 | $110.82 | $110.82 | |
United
| Professional | $68.06 | $102.11 | $102.11 |