| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.22 | $124.05 | $201.00 | |
CDPHP
| Facility | $183.63 | $183.63 | $183.63 | |
Cigna
| Facility | $111.66 | $111.66 | $111.66 | |
Emblem Health
| Facility | $30.00 | $118.56 | $332.00 | |
MVP Health Care
| Facility | $111.66 | $555.00 | $74,999.25 | |
Univera
| Facility | $93.78 | $93.78 | $467.50 |