| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $136.57 | $136.57 | $136.57 | |
Aetna
| Professional | $136.57 | $136.57 | $136.57 | |
CareFirst
| Professional | $379.00 | $379.00 | $413.11 | |
Kaiser Permanente
| Professional | $158.41 | $343.40 | $343.40 |