| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.07 | $18.07 | $18.07 | |
Aetna
| Professional | $18.07 | $18.07 | $18.07 | |
Medcost
| Facility | $18.07 | $18.07 | $27.12 | |
Sentara
| Facility | $1,291.00 | $9,929.00 | $10,945.00 | |
Sentara
| Professional | $1,291.00 | $9,929.00 | $10,945.00 |