| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $68.52 | $68.52 | $411.26 | |
Cigna
| Facility | $107.04 | $107.04 | $107.04 | |
Cigna
| Professional | $143.52 | $143.52 | $143.52 | |
MVP Health Care
| Facility | $107.04 | $107.04 | $107.04 | |
MVP Health Care
| Professional | $41.57 | $41.57 | $143.52 | |
United
| Professional | $27.94 | $63.96 | $287.82 |