| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $37.46 | $127.74 | $215.32 |
Cigna
| Facility | 26 | $217.08 | $217.08 | $217.08 |
Medica
| Facility | 26 | $175.59 | $175.59 | $175.59 |
Midlands
| Facility | 26 | $81.61 | $83.98 | $217.08 |