| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $398.87 | $398.87 | $398.87 | |
CareFirst
| Professional | $527.05 | $527.05 | $527.05 | |
Kaiser Permanente
| Professional | $489.27 | $489.27 | $489.27 | |
United
| Professional | $255.30 | $384.24 | $384.24 |