| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $174.30 | $174.30 | $201.11 | |
Cigna
| Facility | $218.57 | $218.57 | $262.52 | |
Cigna
| Professional | $159.56 | $218.57 | $225.13 | |
MVP Health Care
| Facility | $218.57 | $218.57 | $262.52 | |
MVP Health Care
| Professional | $159.56 | $218.57 | $225.13 | |
United
| Professional | $123.55 | $211.58 | $412.91 |