| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.53 | $96.53 | $96.53 | |
Aetna
| Professional | $68.92 | $89.04 | $96.53 | |
Cigna
| Professional | $210.27 | $210.27 | $210.27 | |
Medica
| Facility | $89.04 | $99.00 | $128.06 | |
Medica
| Professional | $85.75 | $116.25 | $261.44 | |
Midlands
| Facility | $90.23 | $179.03 | $222.49 | |
Midlands
| Professional | $117.93 | $215.53 | $218.37 | |
United
| Professional | $88.21 | $116.25 | $194.40 |