| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $44.46 | $241.66 | $407.34 |
Cigna
| Facility | 26 | $254.10 | $254.10 | $254.10 |
Medica
| Facility | 26 | $207.37 | $207.37 | $207.37 |
Midlands
| Facility | 26 | $147.66 | $151.96 | $254.10 |