| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $73.70 | $146.28 | $284.69 |
Cigna
| Facility | 26 | $74.45 | $74.45 | $74.45 |
MVP Health Care
| Facility | 26 | $74.45 | $74.45 | $74.45 |
Univera
| Facility | 26 | $120.02 | $120.02 | $782.12 |