| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $119.58 | $119.58 | $119.58 | |
Aetna
| Professional | $119.58 | $119.58 | $119.58 | |
CareFirst
| Professional | $112.54 | $112.54 | $112.54 | |
Cigna
| Facility | $119.58 | $119.58 | $119.58 | |
United
| Professional | $106.69 | $117.24 | $190.02 |