| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.42 | $120.42 | $120.42 | |
Aetna
| Professional | $99.14 | $120.42 | $131.21 | |
Cigna
| Professional | $104.45 | $104.45 | $214.50 | |
MVP Health Care
| Professional | $104.45 | $104.45 | $214.50 | |
United
| Professional | $127.26 | $175.97 | $339.39 |