| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $148.22 | $148.22 | $171.03 | |
Cigna
| Facility | $166.52 | $166.52 | $223.25 | |
Cigna
| Professional | $121.56 | $166.52 | $177.52 | |
MVP Health Care
| Facility | $166.52 | $166.52 | $223.25 | |
MVP Health Care
| Professional | $121.56 | $166.52 | $177.52 | |
United
| Professional | $105.06 | $228.27 | $351.15 |