| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $89.21 | $125.00 | $165.51 |
Cigna
| Facility | 26 | $83.32 | $83.32 | $83.32 |
MVP Health Care
| Facility | 26 | $83.32 | $83.32 | $83.32 |
Univera
| Facility | 26 | $77.94 | $77.94 | $248.52 |