| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $13.04 | $22.13 | $88.98 |
Cigna
| Facility | 26 | $55.34 | $57.00 | $58.66 |
Hally Health
| Professional | 26 | $12.16 | $21.68 | $50.34 |
Medica
| Facility | 26 | $57.00 | $115.00 | $115.00 |
Midlands
| Facility | 26 | $57.00 | $58.66 | $72.23 |