| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $588.84 | $588.84 | $3,715.35 | |
Aetna
| Professional | $316.23 | $1,698.24 | $4,365.16 | |
CareFirst
| Professional | $758.58 | $758.58 | $758.58 | |
United
| Facility | $128.82 | $128.82 | $128.82 |