| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $57.53 | $57.53 | $69.30 | |
Cigna
| Facility | $75.05 | $75.05 | $75.05 | |
Cigna
| Professional | $54.79 | $54.79 | $135.01 | |
MVP Health Care
| Facility | $75.05 | $75.05 | $75.05 | |
MVP Health Care
| Professional | $54.79 | $54.79 | $135.01 | |
United
| Professional | $38.85 | $89.37 | $150.52 |