| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.50 | $58.50 | $61.46 | |
CDPHP
| Facility | $91.84 | $91.84 | $91.84 | |
Cigna
| Facility | $77.56 | $77.56 | $77.56 | |
Emblem Health
| Facility | $88.41 | $88.41 | $134.72 | |
MVP Health Care
| Facility | $77.56 | $77.56 | $597.00 |