| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $317.18 | $317.18 | $317.18 | |
Aetna
| Professional | $317.18 | $317.18 | $317.18 | |
CareFirst
| Professional | $175.07 | $175.07 | $175.07 | |
Kaiser Permanente
| Professional | $333.24 | $333.24 | $661.50 | |
United
| Professional | $110.83 | $185.14 | $814.85 |