| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.00 | $2,884.03 | $3,630.78 | |
Aetna
| Professional | $85.11 | $288.40 | $1,479.11 | |
CareFirst
| Professional | $2,137.96 | $2,137.96 | $2,137.96 | |
United
| Facility | $128.82 | $128.82 | $128.82 |