| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $227.16 | $1,614.00 | $7,727.00 | |
Aetna
| Professional | $227.16 | $227.16 | $227.16 | |
CareFirst
| Professional | $108.00 | $108.00 | $117.72 | |
Kaiser Permanente
| Professional | $264.39 | $572.59 | $572.59 |