| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5,470.60 | $5,470.60 | $5,470.60 | |
Cigna
| Facility | $7,100.47 | $7,100.47 | $7,100.47 | |
Cigna
| Professional | $6,035.40 | $7,100.47 | $7,313.48 | |
MVP Health Care
| Facility | $7,100.47 | $7,100.47 | $7,100.47 | |
MVP Health Care
| Professional | $7,100.47 | $7,100.47 | $7,313.48 |