| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $322.56 | $322.56 | $322.56 | |
Aetna
| Professional | $322.56 | $322.56 | $322.56 | |
CareFirst
| Professional | $620.50 | $737.60 | $737.60 | |
Kaiser Permanente
| Professional | $363.90 | $363.90 | $1,151.99 | |
United
| Professional | $229.52 | $383.90 | $516.94 |