| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $124.21 | $124.21 | $124.21 | |
Aetna
| Professional | $101.40 | $125.42 | $162.58 | |
Cigna
| Professional | $126.38 | $157.32 | $263.69 | |
MVP Health Care
| Professional | $126.38 | $126.38 | $263.69 | |
United
| Professional | $126.13 | $139.46 | $189.28 |