| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $428.21 | $428.21 | $1,286.00 | |
Cigna
| Facility | $334.75 | $334.75 | $334.75 | |
Cigna
| Professional | $449.22 | $449.22 | $449.22 | |
MVP Health Care
| Facility | $334.75 | $334.75 | $334.75 | |
MVP Health Care
| Professional | $130.00 | $130.00 | $449.22 | |
United
| Professional | $87.36 | $200.00 | $462.08 |