| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $301.68 | $301.68 | $301.68 | |
CareFirst
| Professional | $651.86 | $651.86 | $667.92 | |
Kaiser Permanente
| Professional | $453.62 | $453.62 | $453.62 | |
United
| Professional | $214.66 | $359.05 | $359.05 |