| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $613.14 | $613.14 | $613.14 | |
CareFirst
| Professional | $739.97 | $739.97 | $825.23 | |
Kaiser Permanente
| Professional | $902.23 | $902.23 | $902.23 | |
United
| Professional | $436.28 | $729.73 | $729.73 |