| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $122.80 | $151.27 | $151.27 | |
Cigna
| Professional | $151.27 | $151.27 | $151.27 | |
MVP Health Care
| Professional | $151.27 | $151.27 | $151.27 | |
United
| Professional | $161.79 | $161.79 | $485.37 |