| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $260.01 | $260.01 | $260.01 | |
Aetna
| Professional | $260.01 | $260.01 | $260.01 | |
CareFirst
| Professional | $230.77 | $230.77 | $3,994.50 | |
Cigna
| Facility | $45,483.24 | $59,291.50 | $64,536.96 |