| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $58.38 | $94.93 | $151.66 |
Cigna
| Facility | 26 | $74.83 | $74.83 | $74.83 |
MVP Health Care
| Facility | 26 | $74.83 | $74.83 | $74.83 |
Univera
| Facility | 26 | $75.86 | $75.86 | $230.97 |