| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $537.03 | $537.03 | $537.03 | |
Aetna
| Professional | $537.03 | $537.03 | $870.96 | |
CareFirst
| Professional | $199.53 | $199.53 | $263.03 | |
United
| Facility | $1,698.24 | $1,995.26 | $2,290.87 |