| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $575.05 | $575.05 | $575.05 | |
Cigna
| Facility | $776.21 | $776.21 | $776.21 | |
Cigna
| Professional | $533.17 | $533.17 | $666.48 | |
MVP Health Care
| Facility | $776.21 | $776.21 | $776.21 | |
MVP Health Care
| Professional | $301.44 | $533.17 | $666.48 | |
United
| Professional | $278.26 | $278.26 | $649.26 |