| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $54.03 | $72.36 | $72.36 | |
Cigna
| Facility | $78.94 | $78.94 | $78.94 | |
Cigna
| Professional | $67.09 | $67.09 | $67.09 | |
MVP Health Care
| Facility | $78.94 | $78.94 | $78.94 | |
United
| Professional | $42.74 | $78.18 | $106.86 |