| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $152.26 | $187.57 | $187.57 | |
Cigna
| Facility | $302.63 | $302.63 | $302.63 | |
Cigna
| Professional | $187.57 | $187.57 | $187.57 | |
MVP Health Care
| Facility | $302.63 | $302.63 | $302.63 | |
MVP Health Care
| Professional | $187.57 | $187.57 | $187.57 |