| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $118.46 | $118.46 | $118.46 | |
CareFirst
| Professional | $214.02 | $214.02 | $221.51 | |
Kaiser Permanente
| Professional | $119.41 | $119.41 | $119.41 | |
United
| Professional | $76.18 | $114.27 | $196.58 |