| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.95 | $46.77 | $72.44 | |
Medcost
| Facility | $5.89 | $5.89 | $7.41 | |
Sentara
| Facility | $100.00 | $1,288.25 | $4,073.80 | |
Sentara
| Professional | $100.00 | $1,288.25 | $4,073.80 |