| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $368.53 | $368.53 | $368.53 | |
Aetna
| Professional | $112.20 | $246.23 | $246.23 | |
CareFirst
| Professional | $245.00 | $245.00 | $1,170.00 | |
Kaiser Permanente
| Professional | $85.00 | $310.00 | $603.00 | |
Wellpoint
| Professional | $125.00 | $270.00 | $270.00 |