| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $66.28 | $66.28 | $66.28 | |
CareFirst
| Professional | $112.65 | $112.65 | $112.65 | |
Kaiser Permanente
| Professional | $72.92 | $72.92 | $72.92 | |
United
| Professional | $42.60 | $63.90 | $63.90 |