| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $158.63 | $158.63 | $158.63 | |
Aetna
| Professional | $158.63 | $169.89 | $223.71 | |
Cigna
| Professional | $45.05 | $45.05 | $45.05 | |
MVP Health Care
| Professional | $45.05 | $45.05 | $45.05 | |
United
| Professional | $161.71 | $161.71 | $161.71 |