| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $441.16 | $441.16 | $441.16 | |
Aetna
| Professional | $336.00 | $429.48 | $441.16 | |
Cigna
| Professional | $88.76 | $88.76 | $88.76 | |
MVP Health Care
| Professional | $88.76 | $88.76 | $88.76 |