| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $110.20 | $110.20 | $110.20 | |
Aetna
| Professional | $110.20 | $110.20 | $110.20 | |
CareFirst
| Professional | $35.53 | $46.92 | $102.68 | |
Cigna
| Facility | $81.48 | $88.10 | $100.68 | |
Cigna
| Professional | $62.78 | $62.78 | $78.47 |