| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $45.18 | $45.18 | $137.60 |
Cigna
| Facility | 26 | $85.04 | $87.59 | $90.14 |
Hally Health
| Professional | 26 | $24.54 | $44.22 | $80.34 |
Medica
| Facility | 26 | $87.59 | $87.59 | $87.59 |
Midlands
| Facility | 26 | $87.59 | $90.14 | $146.10 |