| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $106.59 | $141.56 | $202.54 |
Cigna
| Facility | 26 | $127.27 | $127.27 | $127.27 |
MVP Health Care
| Facility | 26 | $127.27 | $127.27 | $127.27 |
Univera
| Facility | 26 | $201.95 | $201.95 | $583.13 |