| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $131.83 | $131.83 | $131.83 | |
Aetna
| Professional | $131.83 | $131.83 | $371.54 | |
CareFirst
| Professional | $112.20 | $199.53 | $416.87 | |
Cigna
| Facility | $81.28 | $87.10 | $104.71 | |
United
| Facility | $213.80 | $251.19 | $288.40 |