| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $53.50 | $169.92 | $286.42 |
Cigna
| Facility | 26 | $307.32 | $307.32 | $307.32 |
Medica
| Facility | 26 | $248.27 | $248.27 | $248.27 |
Midlands
| Facility | 26 | $108.76 | $111.93 | $307.32 |