| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.90 | $56.23 | $56.23 | |
Aetna
| Professional | $38.90 | $53.70 | $57.54 | |
Cigna
| Professional | $85.11 | $85.11 | $85.11 | |
Medica
| Facility | $52.48 | $79.43 | $95.50 | |
Medica
| Professional | $53.70 | $85.11 | $338.84 | |
Midlands
| Professional | $64.57 | $64.57 | $70.79 | |
United
| Professional | $54.95 | $85.11 | $117.49 |