| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $444.97 | $444.97 | $444.97 | |
Cigna
| Facility | $540.54 | $540.54 | $540.54 | |
Cigna
| Professional | $370.87 | $370.87 | $463.59 | |
MVP Health Care
| Facility | $540.54 | $540.54 | $540.54 | |
MVP Health Care
| Professional | $233.25 | $370.87 | $463.59 | |
United
| Professional | $193.78 | $215.31 | $502.39 |