| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.36 | $10.36 | $10.36 | |
Cigna
| Facility | $57.22 | $57.22 | $57.22 | |
Cigna
| Professional | $39.24 | $39.24 | $49.04 | |
MVP Health Care
| Facility | $57.22 | $57.22 | $57.22 | |
MVP Health Care
| Professional | $22.79 | $39.24 | $49.04 | |
United
| Professional | $14.93 | $21.04 | $49.08 |