| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $48.16 | $85.97 | $157.52 |
Cigna
| Facility | 26 | $78.06 | $78.06 | $78.06 |
MVP Health Care
| Facility | 26 | $78.06 | $78.06 | $78.06 |
Univera
| Facility | 26 | $73.20 | $73.20 | $244.12 |