| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $69.69 | $69.69 | $80.42 | |
Cigna
| Facility | $81.70 | $81.70 | $104.97 | |
Cigna
| Professional | $59.64 | $81.70 | $87.10 | |
MVP Health Care
| Facility | $81.70 | $81.70 | $104.97 | |
MVP Health Care
| Professional | $59.64 | $81.70 | $87.10 | |
United
| Professional | $47.50 | $84.60 | $165.11 |