| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $54.59 | $77.92 | $93.94 |
Cigna
| Facility | 26 | $58.79 | $58.79 | $58.79 |
MVP Health Care
| Facility | 26 | $58.79 | $58.79 | $58.79 |
Univera
| Facility | 26 | $70.02 | $70.02 | $277.20 |