| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $123.80 | $123.80 | $123.80 | |
Cigna
| Facility | $116.79 | $145.38 | $242.32 | |
Cigna
| Professional | $123.80 | $123.80 | $242.32 | |
MVP Health Care
| Facility | $116.79 | $145.38 | $242.32 | |
MVP Health Care
| Professional | $123.80 | $123.80 | $242.32 | |
United
| Professional | $123.80 | $123.80 | $371.40 |