| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $85.09 | $85.09 | $98.18 | |
Cigna
| Facility | $120.06 | $120.06 | $128.16 | |
Cigna
| Professional | $87.64 | $120.06 | $127.99 | |
MVP Health Care
| Facility | $120.06 | $120.06 | $128.16 | |
MVP Health Care
| Professional | $87.64 | $120.06 | $127.99 | |
United
| Professional | $58.00 | $103.29 | $201.58 |