| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $105.00 | $186.00 | $186.00 | |
Cigna
| Facility | $251.06 | $251.06 | $251.06 | |
MVP Health Care
| Facility | $251.06 | $251.06 | $251.06 | |
MVP Health Care
| Professional | $97.50 | $97.50 | $97.50 | |
United
| Professional | $65.52 | $150.00 | $675.00 |