| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $216.00 | $216.00 | $237.60 | |
Cigna
| Facility | $542.48 | $542.48 | $542.48 | |
Cigna
| Professional | $303.38 | $303.38 | $303.38 | |
MVP Health Care
| Facility | $542.48 | $542.48 | $542.48 | |
MVP Health Care
| Professional | $303.38 | $303.38 | $303.38 |