| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $494.00 | $570.00 | $570.00 | |
CareFirst
| Professional | $608.00 | $684.00 | $779.76 | |
Kaiser Permanente
| Professional | $760.00 | $912.00 | $1,326.96 | |
United
| Professional | $319.20 | $380.00 | $691.58 | |
Wellpoint
| Professional | $380.00 | $380.00 | $380.00 |