| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $170.57 | $170.57 | $196.81 | |
Cigna
| Facility | $231.66 | $231.66 | $231.66 | |
Cigna
| Professional | $169.11 | $169.11 | $246.96 | |
MVP Health Care
| Facility | $231.66 | $231.66 | $231.66 | |
MVP Health Care
| Professional | $169.11 | $231.66 | $246.96 | |
United
| Professional | $116.25 | $240.47 | $404.07 |