| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $77.05 | $77.05 | $77.05 | |
Cigna
| Facility | $104.00 | $104.00 | $104.00 | |
Cigna
| Professional | $71.45 | $71.45 | $89.31 | |
MVP Health Care
| Facility | $104.00 | $104.00 | $104.00 | |
MVP Health Care
| Professional | $40.39 | $71.45 | $89.31 | |
United
| Professional | $33.60 | $37.28 | $87.00 |