| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $109.86 | $109.86 | $126.77 | |
Cigna
| Facility | $165.47 | $194.51 | $194.51 | |
Cigna
| Professional | $140.29 | $169.56 | $207.36 | |
MVP Health Care
| Facility | $165.47 | $194.51 | $194.51 | |
MVP Health Care
| Professional | $140.29 | $194.51 | $207.36 | |
United
| Professional | $74.88 | $169.19 | $260.27 |