| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $115.07 | $130.00 | $130.00 | |
Cigna
| Facility | $263.19 | $263.19 | $263.19 | |
Cigna
| Professional | $106.67 | $144.75 | $144.75 | |
MVP Health Care
| Facility | $263.19 | $263.19 | $263.19 | |
MVP Health Care
| Professional | $106.67 | $144.75 | $144.75 |