| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $63.03 | $75.51 | $79.26 | |
Emblem Health
| Professional | $47.00 | $95.10 | $95.41 | |
MVP Health Care
| Facility | $68.03 | $68.03 | $68.03 | |
MVP Health Care
| Professional | $63.03 | $75.51 | $79.26 |