| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $65.67 | $72.23 | $95.22 | |
Cigna
| Facility | $165.16 | $165.16 | $165.16 | |
Cigna
| Professional | $72.25 | $72.25 | $72.25 | |
MVP Health Care
| Facility | $165.16 | $165.16 | $165.16 | |
MVP Health Care
| Professional | $72.25 | $72.25 | $72.25 | |
United
| Professional | $69.73 | $77.26 | $118.85 |