| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $75.00 | $75.00 | $75.00 | |
BCBS
| Facility | $423.09 | $423.09 | $423.09 | |
Cigna
| Facility | $281.27 | $281.27 | $428.40 | |
MVP Health Care
| Facility | $281.27 | $281.27 | $428.40 | |
MVP Health Care
| Professional | $160.00 | $160.00 | $160.00 |