| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $62.30 | $150.07 | $277.91 |
Cigna
| Facility | 26 | $143.36 | $147.66 | $151.96 |
Hally Health
| Professional | 26 | $42.89 | $65.01 | $79.40 |
Medica
| Facility | 26 | $147.66 | $147.66 | $147.66 |
Midlands
| Facility | 26 | $147.66 | $151.96 | $254.10 |