| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $401.62 | $401.62 | $401.62 | |
Aetna
| Professional | $401.62 | $401.62 | $401.62 | |
CareFirst
| Professional | $189.90 | $189.90 | $189.90 | |
Cigna
| Facility | $255.53 | $277.67 | $317.33 | |
Cigna
| Professional | $280.01 | $350.02 | $474.00 |