| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $520.54 | $520.54 | $520.54 | |
Aetna
| Professional | $520.54 | $520.54 | $520.54 | |
CareFirst
| Professional | $390.00 | $465.00 | $506.85 | |
Kaiser Permanente
| Professional | $605.07 | $1,310.28 | $1,310.28 |