| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $94.52 | $94.52 | $103.97 | |
Cigna
| Facility | $263.19 | $263.19 | $263.19 | |
Cigna
| Professional | $78.77 | $78.77 | $78.77 | |
MVP Health Care
| Facility | $263.19 | $263.19 | $263.19 | |
MVP Health Care
| Professional | $78.77 | $78.77 | $78.77 |