| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $30.00 | $30.00 | $30.00 | |
Cigna
| Facility | $36.85 | $36.85 | $36.85 | |
Cigna
| Professional | $19.32 | $19.32 | $19.32 | |
MVP Health Care
| Facility | $36.85 | $36.85 | $36.85 | |
MVP Health Care
| Professional | $19.32 | $19.32 | $19.32 |