| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $76.09 | $76.09 | $76.09 | |
Cigna
| Facility | $71.78 | $97.75 | $162.91 | |
Cigna
| Professional | $76.09 | $76.09 | $162.91 | |
MVP Health Care
| Facility | $71.78 | $97.75 | $162.91 | |
MVP Health Care
| Professional | $76.09 | $76.09 | $162.91 | |
United
| Professional | $76.09 | $76.09 | $228.27 |