| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.98 | $75.98 | $75.98 | |
Aetna
| Professional | $75.98 | $75.98 | $75.98 | |
CareFirst
| Professional | $75.98 | $75.98 | $75.98 | |
Cigna
| Facility | $75.98 | $75.98 | $75.98 | |
United
| Professional | $67.80 | $74.50 | $120.75 |