| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $441.26 | $441.26 | $441.26 | |
Aetna
| Professional | $441.26 | $441.26 | $441.26 | |
CareFirst
| Professional | $243.56 | $243.56 | $243.56 | |
Kaiser Permanente
| Professional | $463.60 | $463.60 | $920.26 | |
United
| Professional | $154.19 | $248.86 | $1,133.59 |