| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $133.51 | $133.51 | $154.05 | |
Cigna
| Facility | $170.96 | $170.96 | $201.09 | |
Cigna
| Professional | $124.80 | $124.80 | $170.56 | |
MVP Health Care
| Facility | $170.96 | $170.96 | $201.09 | |
MVP Health Care
| Professional | $124.80 | $124.80 | $170.56 | |
United
| Professional | $91.00 | $173.18 | $316.29 |