| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.58 | $29.09 | $31.15 | |
Aetna
| Professional | $100.00 | $110.00 | $250.39 | |
CareFirst
| Professional | $100.00 | $100.00 | $100.00 | |
Cigna
| Professional | $79.34 | $79.34 | $79.34 | |
Medcost
| Facility | $75.00 | $75.00 | $75.00 |