| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $385.18 | $385.18 | $385.18 | |
Aetna
| Professional | $385.18 | $385.18 | $385.18 | |
CareFirst
| Professional | $495.00 | $495.00 | $539.54 | |
Kaiser Permanente
| Professional | $447.74 | $968.81 | $968.81 |