| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $19.76 | $103.26 | $174.05 |
Cigna
| Facility | 26 | $113.04 | $113.04 | $113.04 |
Medica
| Facility | 26 | $100.00 | $100.00 | $100.00 |
Midlands
| Facility | 26 | $65.65 | $67.56 | $113.04 |