| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $76.06 | $99.56 | $140.53 |
Cigna
| Facility | 26 | $88.74 | $88.74 | $88.74 |
MVP Health Care
| Facility | 26 | $88.74 | $88.74 | $88.74 |
Univera
| Facility | 26 | $91.57 | $91.57 | $288.36 |