| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.59 | $50.59 | $50.59 | |
Cigna
| Facility | $107.43 | $107.43 | $107.43 | |
Cigna
| Professional | $20.58 | $47.33 | $91.89 | |
MVP Health Care
| Facility | $107.43 | $107.43 | $107.43 | |
MVP Health Care
| Professional | $20.58 | $47.33 | $91.89 | |
United
| Professional | $24.48 | $38.51 | $62.76 |