| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $66.07 | $91.20 | $281.84 |
Cigna
| Facility | 26 | $165.96 | $165.96 | $165.96 |
Medica
| Facility | 26 | $275.42 | $275.42 | $275.42 |
Midlands
| Professional | 26 | $57.54 | $66.07 | $72.44 |
Midlands
| Facility | 26 | $165.96 | $165.96 | $165.96 |