| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.00 | $40.00 | $40.00 | |
Aetna
| Professional | $40.00 | $40.00 | $40.00 | |
Anthem BCBS
| Professional | $126.41 | $126.41 | $155.43 | |
CareFirst
| Professional | $232.77 | $232.77 | $232.77 | |
Medcost
| Facility | $40.00 | $40.00 | $60.92 | |
Sentara
| Facility | $100.00 | $9,929.00 | $10,945.00 | |
Sentara
| Professional | $100.00 | $9,929.00 | $10,945.00 |