| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $38.57 | $75.59 | $137.60 |
Cigna
| Facility | 26 | $74.36 | $76.59 | $78.81 |
Hally Health
| Professional | 26 | $21.59 | $34.44 | $70.45 |
Medica
| Facility | 26 | $76.59 | $108.06 | $108.06 |
Midlands
| Facility | 26 | $76.59 | $78.81 | $123.84 |