| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.20 | $72.20 | $2,290.00 | |
Aetna
| Professional | $68.70 | $72.20 | $72.20 | |
Medica
| Facility | $88.54 | $119.70 | $194.07 | |
Medica
| Professional | $81.72 | $153.38 | $552.16 | |
Midlands
| Facility | $85.15 | $111.52 | $136.72 | |
Midlands
| Professional | $101.40 | $111.52 | $136.72 | |
United
| Facility | $821.00 | $821.00 | $821.00 | |
United
| Professional | $69.63 | $138.44 | $215.35 |