| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $158.61 | $158.61 | $183.01 | |
Cigna
| Facility | $159.21 | $159.21 | $159.21 | |
Cigna
| Professional | $116.22 | $116.22 | $169.72 | |
MVP Health Care
| Facility | $159.21 | $159.21 | $159.21 | |
MVP Health Care
| Professional | $116.22 | $159.21 | $169.72 | |
United
| Professional | $108.10 | $192.53 | $375.73 |