| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $37.15 | $52.48 | $162.18 |
Cigna
| Facility | 26 | $154.88 | $154.88 | $154.88 |
Medica
| Facility | 26 | $125.89 | $125.89 | $125.89 |
Midlands
| Professional | 26 | $53.70 | $61.66 | $93.33 |
Midlands
| Facility | 26 | $154.88 | $154.88 | $154.88 |