| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $111.15 | $140.79 | $234.99 |
Cigna
| Facility | 26 | $114.94 | $114.94 | $114.94 |
MVP Health Care
| Facility | 26 | $114.94 | $114.94 | $114.94 |
Univera
| Facility | 26 | $117.19 | $117.19 | $287.94 |