| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $111.15 | $175.08 | $481.11 |
Cigna
| Facility | 26 | $135.26 | $135.26 | $135.26 |
MVP Health Care
| Facility | 26 | $135.26 | $135.26 | $135.26 |
Univera
| Facility | 26 | $137.94 | $137.94 | $345.62 |