| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $570.23 | $570.23 | $570.23 | |
Cigna
| Facility | $769.69 | $769.69 | $769.69 | |
Cigna
| Professional | $528.64 | $528.64 | $660.80 | |
MVP Health Care
| Facility | $769.69 | $769.69 | $769.69 | |
MVP Health Care
| Professional | $298.91 | $528.64 | $660.80 | |
United
| Professional | $275.92 | $275.92 | $643.79 |