| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $62.25 | $338.84 | $571.14 |
Cigna
| Facility | 26 | $357.36 | $357.36 | $357.36 |
Medica
| Facility | 26 | $303.95 | $303.95 | $303.95 |
Midlands
| Facility | 26 | $218.98 | $225.36 | $357.36 |