| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.00 | $5.00 | $5.15 | |
Cigna
| Facility | $22.55 | $22.55 | $22.55 | |
Cigna
| Professional | $19.17 | $19.17 | $23.23 | |
MVP Health Care
| Facility | $22.55 | $22.55 | $22.55 | |
MVP Health Care
| Professional | $19.17 | $22.55 | $23.23 |