| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $637.35 | $637.35 | $637.35 | |
Aetna
| Professional | $637.35 | $637.35 | $637.35 | |
CareFirst
| Professional | $946.30 | $1,200.70 | $1,200.70 | |
Kaiser Permanente
| Professional | $955.87 | $955.87 | $2,276.21 | |
United
| Professional | $453.51 | $758.54 | $985.81 |