| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $103.74 | $103.74 | $1,959.93 | |
Cigna
| Facility | $510.18 | $510.18 | $510.18 | |
Cigna
| Professional | $685.19 | $685.19 | $685.19 | |
MVP Health Care
| Facility | $510.18 | $510.18 | $510.18 | |
MVP Health Care
| Professional | $150.00 | $150.00 | $685.19 | |
United
| Professional | $128.02 | $304.81 | $704.23 |