| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.55 | $190.55 | $190.55 | |
Aetna
| Professional | $123.03 | $173.78 | $223.87 | |
CareFirst
| Professional | $223.87 | $251.19 | $275.42 | |
Kaiser Permanente
| Professional | $218.78 | $234.42 | $478.63 |