| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $80.04 | $80.04 | $80.04 | |
Cigna
| Facility | $75.51 | $90.61 | $151.02 | |
Cigna
| Professional | $80.04 | $80.04 | $151.02 | |
MVP Health Care
| Facility | $75.51 | $90.61 | $151.02 | |
MVP Health Care
| Professional | $80.04 | $80.04 | $151.02 | |
United
| Professional | $80.04 | $80.04 | $240.12 |