| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $125.00 | $151.87 | $237.11 |
Cigna
| Facility | 26 | $117.01 | $117.01 | $117.01 |
MVP Health Care
| Facility | 26 | $117.01 | $117.01 | $117.01 |
Univera
| Facility | 26 | $109.51 | $109.51 | $131.51 |