| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $425.15 | $582.29 | $582.29 | |
Cigna
| Facility | $422.72 | $422.72 | $422.72 | |
Cigna
| Professional | $359.31 | $359.31 | $359.31 | |
MVP Health Care
| Facility | $422.72 | $422.72 | $422.72 | |
United
| Professional | $292.48 | $487.44 | $731.20 |