| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57.54 | $57.54 | $57.54 | |
Aetna
| Professional | $57.54 | $57.54 | $107.15 | |
CareFirst
| Professional | $162.18 | $162.18 | $213.80 | |
United
| Facility | $1,584.89 | $1,862.09 | $2,137.96 | |
United
| Professional | $81.28 | $81.28 | $81.28 |