| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $193.39 | $193.39 | $193.39 | |
Aetna
| Professional | $188.08 | $193.39 | $193.39 | |
Medica
| Facility | $256.58 | $317.86 | $873.48 | |
Medica
| Professional | $222.77 | $364.54 | $425.29 | |
Midlands
| Facility | $257.30 | $339.85 | $373.67 | |
Midlands
| Professional | $257.30 | $373.67 | $487.46 | |
United
| Professional | $230.88 | $364.54 | $405.04 |