| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $371.54 | $371.54 | $371.54 | |
Aetna
| Professional | $371.54 | $371.54 | $371.54 | |
CareFirst
| Professional | $208.93 | $229.09 | $263.03 | |
Cigna
| Professional | $7,413.10 | $7,413.10 | $7,413.10 |