| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $91.99 | $111.16 | $159.05 |
Cigna
| Facility | 26 | $99.24 | $99.24 | $99.24 |
MVP Health Care
| Facility | 26 | $99.24 | $99.24 | $99.24 |
Univera
| Facility | 26 | $120.07 | $120.07 | $359.70 |