| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $110.01 | $110.01 | $110.01 | |
Aetna
| Professional | $110.01 | $110.01 | $110.01 | |
CareFirst
| Professional | $111.85 | $111.85 | $111.85 | |
Kaiser Permanente
| Professional | $241.18 | $241.18 | $241.18 | |
United
| Professional | $117.77 | $129.41 | $209.76 |