| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $33.65 | $67.01 | $124.24 |
Cigna
| Facility | 26 | $66.15 | $68.13 | $70.12 |
Hally Health
| Professional | 26 | $19.07 | $31.28 | $65.01 |
Medica
| Facility | 26 | $68.13 | $68.13 | $68.13 |
Midlands
| Facility | 26 | $68.13 | $70.12 | $114.66 |