| 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 | $175.85 | |
CareFirst
| Professional | $149.71 | $149.71 | $149.71 | |
United
| Professional | $136.80 | $136.80 | $145.01 |