| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $22.05 | $115.43 | $194.56 |
Cigna
| Facility | 26 | $126.30 | $126.30 | $126.30 |
Medica
| Facility | 26 | $101.42 | $101.42 | $101.42 |
Midlands
| Facility | 26 | $73.84 | $75.98 | $126.30 |