| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $71.28 | $72.43 | $72.43 |
Cigna
| Facility | 26 | $419.34 | $419.34 | $419.34 |
Medica
| Facility | 26 | $334.57 | $334.57 | $334.57 |
Midlands
| Facility | 26 | $225.82 | $232.39 | $419.34 |