| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $695.78 | $695.78 | $695.78 | |
Cigna
| Facility | $405.00 | $405.00 | $413.10 | |
Cigna
| Professional | $344.25 | $405.00 | $417.15 | |
MVP Health Care
| Facility | $405.00 | $405.00 | $413.10 | |
MVP Health Care
| Professional | $405.00 | $405.00 | $417.15 |