| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $50.12 | $69.18 | $218.78 |
Cigna
| Facility | 26 | $123.03 | $123.03 | $123.03 |
Medica
| Facility | 26 | $107.15 | $107.15 | $107.15 |
Midlands
| Professional | 26 | $42.66 | $50.12 | $77.62 |
Midlands
| Facility | 26 | $123.03 | $123.03 | $123.03 |