| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $22.36 | $119.35 | $201.17 |
Cigna
| Facility | 26 | $128.10 | $128.10 | $128.10 |
Medica
| Facility | 26 | $117.00 | $117.00 | $117.00 |
Midlands
| Facility | 26 | $74.78 | $76.95 | $128.10 |