| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $105.89 | $105.89 | $105.89 | |
Aetna
| Professional | $97.95 | $108.96 | $133.91 | |
Cigna
| Professional | $83.40 | $298.50 | $298.50 | |
MVP Health Care
| Professional | $83.40 | $298.50 | $298.50 | |
United
| Professional | $154.11 | $164.37 | $462.60 |