| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.81 | $63.81 | $63.81 | |
Aetna
| Professional | $52.03 | $64.69 | $83.66 | |
Cigna
| Professional | $64.75 | $76.34 | $176.40 | |
MVP Health Care
| Professional | $64.75 | $134.97 | $176.40 | |
United
| Professional | $66.84 | $80.65 | $132.56 |