| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $54.95 | $77.62 | $234.42 |
Cigna
| Facility | 26 | $218.78 | $218.78 | $218.78 |
Medica
| Facility | 26 | $173.78 | $173.78 | $173.78 |
Midlands
| Professional | 26 | $75.86 | $85.11 | $131.83 |
Midlands
| Facility | 26 | $218.78 | $218.78 | $218.78 |