| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $106.00 | $120.36 | $195.59 |
Cigna
| Facility | 26 | $97.61 | $97.61 | $97.61 |
MVP Health Care
| Facility | 26 | $97.61 | $97.61 | $97.61 |
Univera
| Facility | 26 | $99.62 | $99.62 | $289.22 |