| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $100.38 | $128.83 | $184.33 |
Cigna
| Facility | 26 | $114.78 | $114.78 | $114.78 |
MVP Health Care
| Facility | 26 | $114.78 | $114.78 | $114.78 |
Univera
| Facility | 26 | $139.01 | $139.01 | $393.75 |