| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $736.09 | $736.09 | $736.09 | |
Aetna
| Professional | $153.51 | $164.86 | $185.84 | |
CareFirst
| Professional | $202.50 | $228.00 | $260.60 | |
Kaiser Permanente
| Professional | $191.84 | $247.47 | $394.25 |