| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $906.15 | $906.15 | $906.15 | |
Aetna
| Professional | $906.15 | $906.15 | $906.15 | |
CareFirst
| Professional | $1,374.50 | $1,620.60 | $1,620.60 | |
Kaiser Permanente
| Professional | $1,388.19 | $1,388.19 | $3,236.22 | |
United
| Professional | $644.78 | $1,078.46 | $1,400.68 |