| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $22.30 | $175.65 | $296.08 |
Cigna
| Facility | 26 | $129.54 | $129.54 | $129.54 |
Medica
| Facility | 26 | $147.54 | $147.54 | $147.54 |
Midlands
| Facility | 26 | $110.00 | $113.21 | $129.54 |