| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $96.62 | $168.26 | $397.12 |
Cigna
| Facility | 26 | $137.06 | $137.06 | $137.06 |
MVP Health Care
| Facility | 26 | $137.06 | $137.06 | $137.06 |
Univera
| Facility | 26 | $139.88 | $139.88 | $308.44 |