| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $204.22 | $204.22 | $204.22 | |
Aetna
| Professional | $204.22 | $217.26 | $278.10 | |
Cigna
| Professional | $65.81 | $65.81 | $65.81 | |
MVP Health Care
| Professional | $65.81 | $65.81 | $65.81 | |
United
| Professional | $207.49 | $207.49 | $207.49 |