| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $38.02 | $53.70 | $162.18 |
Cigna
| Facility | 26 | $95.50 | $95.50 | $95.50 |
Medica
| Facility | 26 | $77.62 | $77.62 | $77.62 |
Midlands
| Professional | 26 | $33.11 | $38.02 | $42.66 |
Midlands
| Facility | 26 | $95.50 | $95.50 | $95.50 |