| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $39.49 | $50.98 | $66.77 |
Cigna
| Facility | 26 | $40.45 | $40.45 | $40.45 |
MVP Health Care
| Facility | 26 | $40.45 | $40.45 | $40.45 |
Univera
| Facility | 26 | $65.48 | $65.48 | $245.76 |