| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.53 | $87.53 | $87.53 | |
Aetna
| Professional | $78.64 | $87.53 | $112.53 | |
Cigna
| Professional | $55.00 | $70.00 | $115.00 | |
MVP Health Care
| Professional | $55.00 | $70.00 | $115.00 | |
United
| Professional | $119.73 | $131.00 | $366.62 |