| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $45.99 | $73.88 | $118.27 |
Cigna
| Facility | 26 | $59.32 | $59.32 | $59.32 |
MVP Health Care
| Facility | 26 | $59.32 | $59.32 | $59.32 |
Univera
| Facility | 26 | $60.12 | $60.12 | $182.81 |