| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $76.31 | $102.21 | $102.21 | |
Cigna
| Facility | $111.50 | $111.50 | $111.50 | |
Cigna
| Professional | $94.78 | $111.50 | $111.50 | |
MVP Health Care
| Facility | $111.50 | $111.50 | $111.50 | |
MVP Health Care
| Professional | $111.50 | $111.50 | $111.50 | |
United
| Professional | $57.12 | $124.64 | $158.28 |