| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.42 | $20.42 | $20.42 | |
Aetna
| Professional | $19.50 | $19.95 | $28.18 | |
CareFirst
| Professional | $30.90 | $30.90 | $30.90 | |
Kaiser Permanente
| Professional | $38.02 | $38.02 | $38.02 | |
United
| Facility | $20.42 | $20.42 | $20.42 | |
United
| Professional | $19.50 | $19.50 | $20.89 |