| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $143.31 | $143.31 | $143.31 | |
Aetna
| Professional | $143.31 | $143.31 | $143.31 | |
CareFirst
| Professional | $134.88 | $134.88 | $134.88 | |
Cigna
| Facility | $143.31 | $143.31 | $143.31 | |
United
| Professional | $127.86 | $140.50 | $227.72 |