| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $101.72 | $101.72 | $296.20 | |
Cigna
| Facility | $95.96 | $115.68 | $192.80 | |
Cigna
| Professional | $101.72 | $101.72 | $192.80 | |
MVP Health Care
| Facility | $95.96 | $115.68 | $192.80 | |
MVP Health Care
| Professional | $101.72 | $101.72 | $192.80 | |
United
| Professional | $101.72 | $101.72 | $305.16 |