| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $253.85 | $253.85 | $253.85 | |
CareFirst
| Professional | $397.90 | $397.90 | $397.90 | |
Kaiser Permanente
| Professional | $265.43 | $265.43 | $265.43 | |
United
| Professional | $153.69 | $244.82 | $244.82 |