| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.88 | $28.88 | $28.88 | |
Aetna
| Professional | $28.88 | $28.88 | $28.88 | |
CareFirst
| Professional | $30.02 | $30.02 | $30.02 | |
Cigna
| Facility | $28.88 | $28.88 | $28.88 | |
United
| Professional | $25.77 | $28.32 | $45.90 |