| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $84.50 | $84.50 | $84.50 | |
CareFirst
| Professional | $117.58 | $117.58 | $117.58 | |
Kaiser Permanente
| Professional | $104.17 | $104.17 | $104.17 | |
United
| Professional | $54.27 | $81.40 | $81.40 |