| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $138.66 | $138.66 | $159.99 | |
Cigna
| Facility | $144.84 | $144.84 | $208.84 | |
Cigna
| Professional | $105.73 | $105.73 | $144.13 | |
MVP Health Care
| Facility | $144.84 | $144.84 | $208.84 | |
MVP Health Care
| Professional | $105.73 | $105.73 | $144.13 | |
United
| Professional | $94.50 | $168.31 | $328.48 |