| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.00 | $48.00 | $48.00 | |
Aetna
| Professional | $32.50 | $48.00 | $516.00 | |
Cigna
| Professional | $90.00 | $156.00 | $202.60 | |
MVP Health Care
| Professional | $80.00 | $122.00 | $187.50 |