| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $30.52 | $164.85 | $277.86 |
Cigna
| Facility | 26 | $175.02 | $175.02 | $175.02 |
Medica
| Facility | 26 | $143.13 | $143.13 | $143.13 |
Midlands
| Facility | 26 | $103.24 | $106.24 | $175.02 |