| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.93 | $26.93 | $26.93 | |
Aetna
| Professional | $26.93 | $26.93 | $26.93 | |
CareFirst
| Professional | $31.98 | $31.98 | $31.98 | |
Kaiser Permanente
| Professional | $100.29 | $100.29 | $100.29 | |
United
| Professional | $16.80 | $29.99 | $43.08 |