| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $756.33 | $756.33 | $872.69 | |
Cigna
| Facility | $1,111.22 | $1,111.22 | $1,111.22 | |
Cigna
| Professional | $811.19 | $811.19 | $811.19 | |
MVP Health Care
| Facility | $1,111.22 | $1,111.22 | $1,111.22 | |
MVP Health Care
| Professional | $811.19 | $811.19 | $811.19 | |
United
| Professional | $515.48 | $1,066.57 | $1,791.73 |