| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $29.43 | $71.63 | $132.74 |
Cigna
| Facility | 26 | $71.69 | $73.84 | $75.98 |
Hally Health
| Professional | 26 | $20.98 | $33.84 | $71.38 |
Medica
| Facility | 26 | $73.84 | $73.84 | $73.84 |
Midlands
| Facility | 26 | $73.84 | $75.98 | $126.30 |