| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $328.81 | $328.81 | $328.81 | |
Aetna
| Professional | $328.81 | $328.81 | $328.81 | |
CareFirst
| Professional | $374.40 | $374.40 | $408.10 | |
Kaiser Permanente
| Professional | $382.58 | $826.98 | $826.98 |