| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $263.03 | $316.23 | $467.74 | |
Cigna
| Facility | $630.96 | $630.96 | $630.96 | |
Cigna
| Professional | $371.54 | $371.54 | $371.54 | |
MVP Health Care
| Facility | $371.54 | $371.54 | $371.54 | |
MVP Health Care
| Professional | $371.54 | $371.54 | $371.54 | |
United
| Professional | $162.18 | $223.87 | $870.96 |