| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $524.94 | $524.94 | $524.94 | |
Aetna
| Professional | $524.94 | $524.94 | $524.94 | |
CareFirst
| Professional | $1,078.90 | $1,078.90 | $1,078.90 | |
Kaiser Permanente
| Professional | $526.79 | $526.79 | $1,874.76 | |
United
| Professional | $373.52 | $624.76 | $748.36 |