| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.10 | $87.10 | $87.10 | |
Aetna
| Professional | $70.79 | $85.11 | $107.15 | |
Cigna
| Professional | $54.95 | $74.13 | $117.49 | |
MVP Health Care
| Professional | $54.95 | $61.66 | $61.66 | |
United
| Professional | $95.50 | $123.03 | $218.78 |