| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $450.00 | $450.00 | $450.00 | |
Aetna
| Professional | $450.00 | $450.00 | $450.00 | |
CareFirst
| Professional | $551.39 | $551.39 | $551.39 | |
Kaiser Permanente
| Professional | $476.10 | $530.62 | $714.15 | |
United
| Professional | $363.47 | $575.52 | $902.29 | |
Wellpoint
| Professional | $450.00 | $450.00 | $450.00 |