| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $103.22 | $103.22 | $103.22 | |
Aetna
| Professional | $103.22 | $103.22 | $103.22 | |
CareFirst
| Professional | $101.27 | $101.27 | $101.27 | |
Kaiser Permanente
| Professional | $34.11 | $34.11 | $34.11 | |
United
| Professional | $92.08 | $101.19 | $164.01 |