| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $102.95 | $102.95 | $118.79 | |
Cigna
| Facility | $171.65 | $171.65 | $171.65 | |
Cigna
| Professional | $145.90 | $171.65 | $176.80 | |
MVP Health Care
| Facility | $171.65 | $171.65 | $171.65 | |
MVP Health Care
| Professional | $145.90 | $171.65 | $176.80 | |
United
| Professional | $70.17 | $145.19 | $243.90 |