| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $942.40 | $942.40 | $942.40 | |
Cigna
| Facility | $1,272.05 | $1,272.05 | $1,272.05 | |
Cigna
| Professional | $873.50 | $873.50 | $1,091.86 | |
MVP Health Care
| Facility | $1,272.05 | $1,272.05 | $1,272.05 | |
MVP Health Care
| Professional | $494.00 | $873.50 | $1,091.86 | |
United
| Professional | $456.00 | $456.00 | $1,064.00 |