| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.58 | $47.58 | $47.58 | |
Aetna
| Professional | $47.58 | $47.58 | $58.81 | |
Cigna
| Professional | $31.50 | $39.38 | $39.38 | |
Medica
| Facility | $11.43 | $74.17 | $117.62 | |
Medica
| Professional | $132.31 | $223.52 | $340.11 | |
Midlands
| Facility | $63.01 | $154.15 | $400.57 | |
Midlands
| Professional | $121.06 | $154.15 | $336.97 | |
United
| Professional | $32.47 | $216.50 | $268.06 |