| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $262.50 | $465.00 | $465.00 | |
Cigna
| Facility | $627.66 | $627.66 | $627.66 | |
MVP Health Care
| Facility | $627.66 | $627.66 | $627.66 | |
MVP Health Care
| Professional | $243.75 | $243.75 | $243.75 | |
United
| Professional | $163.80 | $375.00 | $1,687.50 |