| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $211.06 | $211.06 | $211.06 | |
Aetna
| Professional | $211.06 | $211.06 | $211.06 | |
CareFirst
| Professional | $133.19 | $133.19 | $145.19 | |
Kaiser Permanente
| Professional | $245.34 | $531.29 | $531.29 |