| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.38 | $42.38 | $42.38 | |
Aetna
| Professional | $42.38 | $42.38 | $42.38 | |
CareFirst
| Professional | $42.28 | $42.28 | $42.28 | |
Kaiser Permanente
| Professional | $2,230.98 | $2,230.98 | $2,230.98 | |
United
| Professional | $38.47 | $42.28 | $68.53 |