| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $318.33 | $390.00 | $390.00 | |
Cigna
| Facility | $263.19 | $263.19 | $263.19 | |
Cigna
| Professional | $280.01 | $350.02 | $359.22 | |
MVP Health Care
| Facility | $263.19 | $263.19 | $263.19 | |
MVP Health Care
| Professional | $280.01 | $350.02 | $359.22 |