| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $51.29 | $72.44 | $218.78 |
Cigna
| Facility | 26 | $128.82 | $128.82 | $128.82 |
Medica
| Facility | 26 | $117.49 | $117.49 | $117.49 |
Midlands
| Professional | 26 | $44.67 | $50.12 | $77.62 |
Midlands
| Facility | 26 | $128.82 | $128.82 | $128.82 |