| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $30.90 | $50.21 | $92.68 |
Cigna
| Facility | 26 | $50.00 | $51.50 | $53.00 |
Hally Health
| Professional | 26 | $14.37 | $23.06 | $52.49 |
Medica
| Facility | 26 | $51.50 | $100.00 | $100.00 |
Midlands
| Facility | 26 | $51.50 | $53.00 | $87.06 |