| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31.57 | $31.57 | $31.57 | |
Aetna
| Professional | $31.57 | $31.57 | $37.79 | |
Cigna
| Professional | $15.75 | $15.91 | $19.69 | |
Medica
| Facility | $11.43 | $49.18 | $75.58 | |
Medica
| Professional | $81.39 | $137.49 | $246.18 | |
Midlands
| Facility | $39.92 | $102.87 | $110.75 | |
Midlands
| Professional | $94.26 | $110.75 | $207.08 | |
United
| Professional | $16.25 | $110.99 | $164.74 |