| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $57.51 | $93.46 | $150.12 |
Cigna
| Facility | 26 | $74.48 | $74.48 | $74.48 |
MVP Health Care
| Facility | 26 | $74.48 | $74.48 | $74.48 |
Univera
| Facility | 26 | $75.47 | $75.47 | $230.97 |