| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $22.36 | $116.08 | $195.66 |
Cigna
| Facility | 26 | $128.10 | $128.10 | $128.10 |
Medica
| Facility | 26 | $134.00 | $134.00 | $134.00 |
Midlands
| Facility | 26 | $74.55 | $76.72 | $128.10 |