| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $386.17 | $386.17 | $386.17 | |
Aetna
| Professional | $386.17 | $386.17 | $386.17 | |
CareFirst
| Professional | $213.16 | $213.16 | $213.16 | |
Kaiser Permanente
| Professional | $405.72 | $405.72 | $805.38 | |
United
| Professional | $134.94 | $217.78 | $992.08 |