| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.95 | $19.95 | $41.69 | |
Cigna
| Facility | $72.44 | $72.44 | $72.44 | |
Cigna
| Professional | $43.65 | $43.65 | $43.65 | |
MVP Health Care
| Facility | $43.65 | $43.65 | $43.65 | |
MVP Health Care
| Professional | $43.65 | $43.65 | $43.65 | |
United
| Professional | $19.05 | $26.30 | $100.00 |