| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $20.96 | $115.58 | $194.82 |
Cigna
| Facility | 26 | $121.32 | $121.32 | $121.32 |
Medica
| Facility | 26 | $129.00 | $129.00 | $129.00 |
Midlands
| Facility | 26 | $74.50 | $76.67 | $121.32 |