| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.28 | $128.28 | $128.28 | |
Aetna
| Professional | $89.10 | $123.69 | $200.08 | |
Cigna
| Professional | $96.42 | $96.42 | $394.13 | |
MVP Health Care
| Professional | $96.42 | $96.42 | $394.13 | |
United
| Professional | $108.68 | $158.88 | $459.33 |