| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.67 | $190.67 | $190.67 | |
Aetna
| Professional | $190.67 | $190.67 | $190.67 | |
CareFirst
| Professional | $388.80 | $388.80 | $388.80 | |
United
| Professional | $17.02 | $25.54 | $37.39 |