| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.31 | $51.31 | $51.31 | |
Aetna
| Professional | $51.31 | $51.31 | $76.95 | |
Cigna
| Facility | $66.37 | $66.37 | $66.37 | |
MVP Health Care
| Facility | $66.37 | $66.37 | $66.37 | |
MVP Health Care
| Professional | $51.31 | $51.31 | $51.31 | |
United
| Professional | $22.41 | $51.33 | $118.55 |