| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $301.57 | $402.61 | $575.13 |
Cigna
| Facility | 26 | $364.61 | $364.61 | $364.61 |
MVP Health Care
| Facility | 26 | $364.61 | $364.61 | $364.61 |
Univera
| Facility | 26 | $443.65 | $443.65 | $584.95 |