| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $74.20 | $74.20 | $74.20 | |
CareFirst
| Professional | $122.76 | $122.76 | $141.19 | |
Kaiser Permanente
| Professional | $116.29 | $116.29 | $116.29 | |
United
| Professional | $52.80 | $88.31 | $88.31 |