| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,182.48 | $2,182.48 | $2,182.48 | |
MVP Health Care
| Facility | $2,182.48 | $2,182.48 | $2,182.48 | |
MVP Health Care
| Professional | $726.69 | $726.69 | $726.69 | |
United
| Professional | $488.33 | $1,533.58 | $5,867.78 |