| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.40 | $104.40 | $104.40 | |
Aetna
| Professional | $104.40 | $104.40 | $104.40 | |
Anthem BCBS
| Professional | $112.22 | $112.22 | $112.22 | |
CareFirst
| Professional | $83.07 | $83.07 | $83.07 | |
Medcost
| Facility | $104.40 | $104.40 | $117.97 |