| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.61 | $17.61 | $17.61 | |
Aetna
| Professional | $17.61 | $17.61 | $22.54 | |
CareFirst
| Professional | $17.61 | $17.61 | $17.61 | |
United
| Professional | $20.72 | $20.72 | $21.96 | |
Wellpoint
| Professional | $17.27 | $17.27 | $17.27 |