| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $143.10 | $143.10 | $143.10 | |
Aetna
| Professional | $143.10 | $143.10 | $254.02 | |
CareFirst
| Professional | $1,002.23 | $1,002.23 | $1,002.23 | |
Cigna
| Professional | $66.81 | $66.81 | $592.28 | |
United
| Professional | $16.18 | $24.26 | $35.08 |