| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $16.22 | $52.48 | $154.88 |
Cigna
| Facility | 26 | $72.44 | $72.44 | $72.44 |
Medica
| Facility | 26 | $114.82 | $114.82 | $114.82 |
Midlands
| Professional | 26 | $25.12 | $28.84 | $44.67 |
Midlands
| Facility | 26 | $72.44 | $72.44 | $72.44 |