| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $67.45 | $67.45 | $67.45 | |
Cigna
| Facility | $107.43 | $107.43 | $107.43 | |
Cigna
| Professional | $27.44 | $63.10 | $91.89 | |
MVP Health Care
| Facility | $107.43 | $107.43 | $107.43 | |
MVP Health Care
| Professional | $27.44 | $63.10 | $91.89 | |
United
| Professional | $28.04 | $38.51 | $83.68 |