| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.61 | $48.61 | $48.61 | |
Aetna
| Professional | $48.61 | $56.02 | $88.76 | |
Cigna
| Professional | $21.75 | $22.19 | $27.62 | |
Medica
| Facility | $56.02 | $90.20 | $153.49 | |
Medica
| Professional | $97.72 | $199.78 | $442.64 | |
Midlands
| Facility | $66.16 | $127.75 | $162.68 | |
Midlands
| Professional | $127.75 | $127.75 | $140.49 | |
United
| Professional | $85.88 | $179.12 | $282.10 |