| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $45.63 | $74.19 | $137.25 |
Cigna
| Facility | 26 | $72.59 | $74.78 | $76.95 |
Hally Health
| Professional | 26 | $21.56 | $35.15 | $56.99 |
Medica
| Facility | 26 | $74.78 | $117.00 | $117.00 |
Midlands
| Facility | 26 | $74.78 | $76.95 | $128.10 |