| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $154.88 | $234.42 | $691.83 |
Cigna
| Facility | 26 | $416.87 | $416.87 | $416.87 |
Medica
| Facility | 26 | $354.81 | $354.81 | $354.81 |
Midlands
| Professional | 26 | $144.54 | $177.83 | $257.04 |
Midlands
| Facility | 26 | $416.87 | $416.87 | $416.87 |