| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $82.33 | $444.56 | $749.35 |
Cigna
| Facility | 26 | $474.30 | $474.30 | $474.30 |
Medica
| Facility | 26 | $799.28 | $799.28 | $799.28 |
Midlands
| Facility | 26 | $270.14 | $278.02 | $474.30 |