| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $82.93 | $82.93 | $1,504.62 | |
Cigna
| Facility | $391.66 | $391.66 | $391.66 | |
Cigna
| Professional | $525.45 | $525.45 | $525.45 | |
MVP Health Care
| Facility | $391.66 | $391.66 | $391.66 | |
MVP Health Care
| Professional | $110.00 | $110.00 | $525.45 | |
United
| Professional | $102.21 | $234.00 | $540.63 |