| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $72.80 | $72.80 | $87.69 | |
Cigna
| Facility | $139.08 | $139.08 | $139.08 | |
Cigna
| Professional | $101.53 | $101.53 | $171.52 | |
MVP Health Care
| Facility | $139.08 | $139.08 | $139.08 | |
MVP Health Care
| Professional | $101.53 | $101.53 | $171.52 | |
United
| Professional | $49.33 | $113.11 | $190.89 |