| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $279.24 | $279.24 | $279.24 | |
Aetna
| Professional | $279.24 | $279.24 | $279.24 | |
CareFirst
| Professional | $515.04 | $515.04 | $515.04 | |
Kaiser Permanente
| Professional | $498.48 | $498.48 | $997.28 | |
United
| Professional | $198.70 | $332.34 | $523.63 |