| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $169.75 | $819.93 | $967.40 | |
Aetna
| Professional | $23.00 | $317.60 | $317.60 | |
CareFirst
| Professional | $180.18 | $180.18 | $239.64 | |
Cigna
| Professional | $116.76 | $116.76 | $178.12 |