| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $128.82 | $128.82 | $194.98 | |
Cigna
| Facility | $331.13 | $331.13 | $331.13 | |
Cigna
| Professional | $199.53 | $199.53 | $199.53 | |
MVP Health Care
| Facility | $199.53 | $199.53 | $199.53 | |
MVP Health Care
| Professional | $199.53 | $199.53 | $199.53 | |
United
| Professional | $87.10 | $199.53 | $457.09 |