| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $32.10 | $32.10 | $32.10 | |
Aetna
| Professional | $31.21 | $32.10 | $32.10 | |
Medica
| Facility | $42.07 | $44.83 | $85.52 | |
Medica
| Professional | $38.34 | $57.90 | $93.30 | |
Midlands
| Facility | $36.34 | $61.40 | $71.11 | |
Midlands
| Professional | $55.84 | $61.40 | $71.11 | |
United
| Professional | $37.94 | $53.59 | $88.86 |