| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $173.78 | $234.42 | $302.00 | |
Cigna
| Facility | $457.09 | $457.09 | $457.09 | |
Cigna
| Professional | $275.42 | $275.42 | $275.42 | |
MVP Health Care
| Facility | $275.42 | $275.42 | $275.42 | |
MVP Health Care
| Professional | $275.42 | $275.42 | $275.42 | |
United
| Professional | $107.15 | $245.47 | $630.96 |