| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $83.92 | $83.92 | $83.92 | |
Cigna
| Professional | $54.28 | $54.28 | $54.28 | |
MVP Health Care
| Facility | $83.92 | $83.92 | $83.92 | |
MVP Health Care
| Professional | $22.35 | $22.35 | $54.28 |