| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $53.65 | $91.72 | $150.21 |
Cigna
| Facility | 26 | $74.26 | $74.26 | $74.26 |
MVP Health Care
| Facility | 26 | $74.26 | $74.26 | $74.26 |
Univera
| Facility | 26 | $75.80 | $75.80 | $212.14 |