| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.80 | $70.80 | $70.80 | |
Aetna
| Professional | $51.60 | $70.80 | $70.80 | |
Cigna
| Professional | $45.92 | $45.92 | $45.92 | |
MVP Health Care
| Professional | $45.92 | $45.92 | $76.34 | |
United
| Professional | $59.85 | $88.20 | $256.39 |