| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $79.43 | $97.72 | $141.25 | |
Cigna
| Facility | $190.55 | $190.55 | $190.55 | |
Cigna
| Professional | $114.82 | $114.82 | $114.82 | |
MVP Health Care
| Facility | $114.82 | $114.82 | $114.82 | |
MVP Health Care
| Professional | $114.82 | $114.82 | $114.82 | |
United
| Professional | $50.12 | $69.18 | $263.03 |