| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $214.21 | $267.58 | $398.56 |
Cigna
| Facility | 26 | $253.61 | $253.61 | $253.61 |
MVP Health Care
| Facility | 26 | $253.61 | $253.61 | $253.61 |
Univera
| Facility | 26 | $402.77 | $402.77 | $1,194.47 |