| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $210.91 | $282.52 | $398.08 | |
CDPHP
| Facility | $322.83 | $322.83 | $322.83 | |
Cigna
| Facility | $253.88 | $253.88 | $253.88 | |
Emblem Health
| Facility | $174.01 | $270.36 | $547.70 | |
MVP Health Care
| Facility | $253.88 | $253.88 | $74,999.25 | |
Univera
| Facility | $307.07 | $307.07 | $679.13 |