| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $72.00 | $72.00 | $72.00 | |
Cigna
| Facility | $52.17 | $52.17 | $52.17 | |
Cigna
| Professional | $38.08 | $38.08 | $53.74 | |
MVP Health Care
| Facility | $52.17 | $52.17 | $52.17 | |
MVP Health Care
| Professional | $38.08 | $52.17 | $53.74 | |
United
| Professional | $69.20 | $145.77 | $263.80 |