| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $365.38 | $500.00 | $500.00 | |
Cigna
| Facility | $83.92 | $83.92 | $83.92 | |
Cigna
| Professional | $109.45 | $136.81 | $279.20 | |
MVP Health Care
| Facility | $83.92 | $83.92 | $83.92 | |
MVP Health Care
| Professional | $109.45 | $136.81 | $279.20 |