| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $279.93 | $279.93 | $279.93 | |
Aetna
| Professional | $279.93 | $279.93 | $279.93 | |
CareFirst
| Professional | $342.00 | $342.00 | $372.78 | |
Kaiser Permanente
| Professional | $325.06 | $704.66 | $704.66 |