| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $157.00 | $157.00 | $157.00 | |
CareFirst
| Professional | $25.00 | $25.00 | $25.00 | |
Cigna
| Professional | $24.99 | $24.99 | $24.99 | |
Wellpoint
| Professional | $12.62 | $12.62 | $12.62 |