| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $9.43 | $9.43 | $10.37 | |
Cigna
| Facility | $263.19 | $263.19 | $263.19 | |
Cigna
| Professional | $269.39 | $269.39 | $269.39 | |
MVP Health Care
| Facility | $263.19 | $263.19 | $263.19 | |
MVP Health Care
| Professional | $269.39 | $269.39 | $269.39 |