| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $54.21 | $54.21 | $54.21 | |
Aetna
| Professional | $54.21 | $54.21 | $56.02 | |
Cigna
| Professional | $67.00 | $67.00 | $67.00 | |
Medica
| Facility | $80.11 | $91.61 | $94.67 | |
Medica
| Professional | $59.19 | $94.99 | $426.56 | |
Midlands
| Facility | $67.00 | $73.68 | $85.33 | |
Midlands
| Professional | $67.00 | $67.00 | $106.93 | |
United
| Professional | $55.86 | $94.19 | $110.82 |