| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $41.65 | $172.56 | $1,585.12 | |
Cigna
| Facility | $412.62 | $412.62 | $412.62 | |
Cigna
| Professional | $339.32 | $372.99 | $553.83 | |
MVP Health Care
| Facility | $412.62 | $412.62 | $412.62 | |
MVP Health Care
| Professional | $55.00 | $372.99 | $553.83 | |
United
| Professional | $107.68 | $247.14 | $569.55 |