| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $23.70 | $41.99 | $41.99 | |
Cigna
| Facility | $56.68 | $56.68 | $56.68 | |
MVP Health Care
| Facility | $56.68 | $56.68 | $56.68 | |
MVP Health Care
| Professional | $22.01 | $22.01 | $22.01 | |
United
| Professional | $14.79 | $33.86 | $152.37 |