| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $24.08 | $130.86 | $220.58 |
Cigna
| Facility | 26 | $138.06 | $138.06 | $138.06 |
Medica
| Facility | 26 | $115.44 | $115.44 | $115.44 |
Midlands
| Facility | 26 | $81.98 | $84.37 | $138.06 |