| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $398.76 | $398.76 | $398.76 | |
CareFirst
| Professional | $730.07 | $730.07 | $741.93 | |
Kaiser Permanente
| Professional | $449.86 | $449.86 | $449.86 | |
United
| Professional | $283.74 | $474.58 | $474.58 |