| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $108.98 | $145.05 | $207.54 |
Cigna
| Facility | 26 | $129.40 | $129.40 | $129.40 |
MVP Health Care
| Facility | 26 | $129.40 | $129.40 | $129.40 |
Univera
| Facility | 26 | $205.29 | $205.29 | $584.03 |