| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $182.35 | $323.02 | $1,675.02 | |
Cigna
| Facility | $436.02 | $436.02 | $436.02 | |
Cigna
| Professional | $299.43 | $374.28 | $585.45 | |
MVP Health Care
| Facility | $436.02 | $436.02 | $436.02 | |
MVP Health Care
| Professional | $169.33 | $299.43 | $585.45 | |
United
| Professional | $113.79 | $156.30 | $601.86 |