| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $87.98 | $87.98 | $87.98 | |
Cigna
| Facility | $83.00 | $107.46 | $179.11 | |
Cigna
| Professional | $87.98 | $87.98 | $179.11 | |
MVP Health Care
| Facility | $83.00 | $107.46 | $179.11 | |
MVP Health Care
| Professional | $87.98 | $87.98 | $179.11 | |
United
| Professional | $87.98 | $87.98 | $263.94 |