| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $164.56 | $164.56 | $189.88 | |
Cigna
| Facility | $192.91 | $192.91 | $192.91 | |
Cigna
| Professional | $140.82 | $192.91 | $256.57 | |
MVP Health Care
| Facility | $192.91 | $192.91 | $192.91 | |
MVP Health Care
| Professional | $140.82 | $192.91 | $256.57 | |
United
| Professional | $112.16 | $199.75 | $389.84 |