| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $36.18 | $64.11 | $118.75 |
Cigna
| Facility | 26 | $63.74 | $65.65 | $67.56 |
Hally Health
| Professional | 26 | $19.12 | $31.33 | $63.74 |
Medica
| Facility | 26 | $65.65 | $65.65 | $65.65 |
Midlands
| Facility | 26 | $65.65 | $67.56 | $113.04 |