| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $483.03 | $483.03 | $483.03 | |
CareFirst
| Professional | $633.57 | $633.57 | $633.57 | |
Kaiser Permanente
| Professional | $594.21 | $594.21 | $594.21 | |
United
| Professional | $308.91 | $465.31 | $465.31 |