| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $65.34 | $106.23 | $196.51 |
Cigna
| Facility | 26 | $102.60 | $105.68 | $108.76 |
Hally Health
| Professional | 26 | $29.43 | $48.53 | $94.22 |
Medica
| Facility | 26 | $105.68 | $105.68 | $105.68 |
Midlands
| Facility | 26 | $105.68 | $108.76 | $178.20 |