| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $31.06 | $67.45 | $109.50 |
Cigna
| Facility | 26 | $51.90 | $51.90 | $51.90 |
MVP Health Care
| Facility | 26 | $51.90 | $51.90 | $51.90 |
Univera
| Facility | 26 | $48.63 | $48.63 | $122.35 |