| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $633.89 | $633.89 | $633.89 | |
Cigna
| Facility | $855.62 | $855.62 | $855.62 | |
Cigna
| Professional | $587.29 | $587.29 | $734.11 | |
MVP Health Care
| Facility | $855.62 | $855.62 | $855.62 | |
MVP Health Care
| Professional | $332.28 | $587.29 | $734.11 | |
United
| Professional | $306.72 | $306.72 | $715.68 |