| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $104.71 | $162.18 | $478.63 |
Cigna
| Facility | 26 | $281.84 | $281.84 | $281.84 |
Medica
| Facility | 26 | $239.88 | $239.88 | $239.88 |
Midlands
| Professional | 26 | $100.00 | $112.20 | $173.78 |
Midlands
| Facility | 26 | $281.84 | $281.84 | $281.84 |