| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $665.00 | $1,178.00 | $1,178.00 | |
Cigna
| Facility | $1,590.06 | $1,590.06 | $1,590.06 | |
MVP Health Care
| Facility | $1,590.06 | $1,590.06 | $1,590.06 | |
MVP Health Care
| Professional | $617.50 | $617.50 | $617.50 | |
United
| Professional | $414.96 | $1,120.91 | $2,194.88 |