| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $134.40 | $238.08 | $238.08 | |
Cigna
| Facility | $642.72 | $642.72 | $642.72 | |
MVP Health Care
| Facility | $642.72 | $642.72 | $642.72 | |
MVP Health Care
| Professional | $124.80 | $124.80 | $124.80 | |
United
| Professional | $83.87 | $268.80 | $887.19 |