| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $65.88 | $65.88 | $65.88 | |
Cigna
| Facility | $62.15 | $73.30 | $122.17 | |
Cigna
| Professional | $65.88 | $65.88 | $122.17 | |
MVP Health Care
| Facility | $62.15 | $73.30 | $122.17 | |
MVP Health Care
| Professional | $65.88 | $65.88 | $122.17 | |
United
| Professional | $65.88 | $69.83 | $197.64 |