| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.34 | $71.34 | $170.94 | |
Aetna
| Professional | $56.50 | $138.40 | $175.07 | |
Cigna
| Professional | $128.26 | $128.26 | $381.75 | |
MVP Health Care
| Professional | $128.26 | $191.42 | $381.75 | |
United
| Professional | $197.34 | $210.48 | $650.92 |