| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $83.92 | $83.92 | $83.92 | |
MVP Health Care
| Facility | $83.92 | $83.92 | $83.92 | |
MVP Health Care
| Professional | $43.53 | $43.53 | $43.53 | |
United
| Professional | $3.00 | $3.00 | $3.00 |