| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.87 | $61.87 | $61.87 | |
Aetna
| Professional | $48.24 | $61.87 | $87.33 | |
Cigna
| Professional | $75.93 | $75.93 | $75.93 | |
Medica
| Facility | $48.24 | $81.53 | $104.56 | |
Medica
| Professional | $49.16 | $98.32 | $564.65 | |
Midlands
| Facility | $56.95 | $134.90 | $167.55 | |
Midlands
| Professional | $134.90 | $148.35 | $255.73 | |
United
| Professional | $49.16 | $88.16 | $103.72 |