| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $150.07 | $150.07 | $150.07 | |
Aetna
| Professional | $150.07 | $150.07 | $150.07 | |
CareFirst
| Professional | $149.71 | $149.71 | $149.71 | |
United
| Professional | $124.49 | $136.80 | $221.72 |