| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,240.00 | $3,968.00 | $3,968.00 | |
Cigna
| Facility | $5,356.00 | $5,356.00 | $5,356.00 | |
MVP Health Care
| Facility | $5,356.00 | $5,356.00 | $5,356.00 | |
MVP Health Care
| Professional | $2,080.00 | $2,080.00 | $2,080.00 | |
United
| Professional | $1,397.76 | $3,697.28 | $14,400.00 |