| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $92.25 | $92.25 | $92.25 | |
Aetna
| Professional | $75.88 | $92.25 | $100.49 | |
Cigna
| Professional | $79.45 | $79.45 | $164.25 | |
MVP Health Care
| Professional | $79.45 | $79.45 | $164.25 | |
United
| Professional | $97.69 | $133.86 | $259.74 |