| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $168.81 | $168.81 | $194.78 | |
Cigna
| Facility | $203.51 | $203.51 | $254.24 | |
Cigna
| Professional | $148.56 | $203.51 | $216.96 | |
MVP Health Care
| Facility | $203.51 | $203.51 | $254.24 | |
MVP Health Care
| Professional | $148.56 | $203.51 | $216.96 | |
United
| Professional | $115.05 | $244.81 | $399.90 |