| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $140.00 | $140.00 | $140.00 | |
Cigna
| Facility | $223.29 | $223.29 | $223.29 | |
Cigna
| Professional | $163.00 | $163.00 | $163.00 | |
MVP Health Care
| Facility | $223.29 | $223.29 | $223.29 | |
MVP Health Care
| Professional | $163.00 | $163.00 | $163.00 | |
United
| Professional | $136.51 | $262.52 | $504.81 |