| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $150.00 | $150.00 | $150.00 | |
Aetna
| Professional | $150.00 | $150.00 | $160.30 | |
Cigna
| Professional | $88.53 | $88.53 | $88.53 | |
MVP Health Care
| Professional | $88.53 | $88.53 | $670.04 | |
United
| Professional | $192.37 | $243.84 | $771.37 |