| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $517.29 | $517.29 | $517.29 | |
Aetna
| Professional | $517.29 | $517.29 | $517.29 | |
CareFirst
| Professional | $980.00 | $980.00 | $1,068.20 | |
Cigna
| Facility | $255.53 | $277.67 | $317.33 |