| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $125.89 | $125.89 | |
Aetna
| Professional | $117.49 | $138.04 | $446.68 | |
CareFirst
| Professional | $138.04 | $151.36 | $223.87 | |
Kaiser Permanente
| Professional | $147.91 | $158.49 | $316.23 |