| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $483.62 | $483.62 | $483.62 | |
CareFirst
| Professional | $633.50 | $633.50 | $706.51 | |
Kaiser Permanente
| Professional | $711.51 | $711.51 | $711.51 | |
United
| Professional | $344.12 | $575.58 | $575.58 |