| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $118.13 | $118.13 | $118.13 | |
Aetna
| Professional | $118.13 | $118.13 | $130.08 | |
Cigna
| Professional | $13.17 | $13.17 | $13.17 | |
MVP Health Care
| Professional | $13.17 | $13.17 | $13.17 |