| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $282.13 | $282.13 | $282.13 | |
Aetna
| Professional | $282.13 | $282.13 | $282.13 | |
CareFirst
| Professional | $400.00 | $400.00 | $446.74 | |
Kaiser Permanente
| Professional | $318.29 | $318.29 | $1,007.59 | |
United
| Professional | $200.75 | $335.78 | $452.15 |