| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | 26 | $9.16 | $10.48 | $37.96 |
Aetna
| Professional | TC | $15.02 | $16.50 | $61.73 |
Cigna
| Professional | 26 | $28.78 | $41.35 | $53.96 |
Cigna
| Professional | TC | $43.17 | $60.98 | $79.38 |
MVP Health Care
| Professional | 26 | $31.27 | $36.29 | $53.96 |
MVP Health Care
| Professional | TC | $46.12 | $54.29 | $79.38 |