| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $287.68 | $287.68 | $287.68 | |
Aetna
| Professional | $287.68 | $287.68 | $287.68 | |
CareFirst
| Professional | $315.00 | $315.00 | $343.35 | |
Kaiser Permanente
| Professional | $334.43 | $724.17 | $724.17 |