| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $122.37 | $216.76 | $216.76 | |
Cigna
| Facility | $292.60 | $292.60 | $292.60 | |
MVP Health Care
| Facility | $292.60 | $292.60 | $292.60 | |
MVP Health Care
| Professional | $113.63 | $113.63 | $113.63 | |
United
| Professional | $76.36 | $175.08 | $786.65 |