| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $53.00 | $53.00 | $53.00 | |
Cigna
| Facility | $50.00 | $112.20 | $187.00 | |
Cigna
| Professional | $53.00 | $53.00 | $187.00 | |
MVP Health Care
| Facility | $50.00 | $112.20 | $187.00 | |
MVP Health Care
| Professional | $53.00 | $53.00 | $187.00 | |
United
| Professional | $53.00 | $53.00 | $159.00 |