| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.44 | $2,290.87 | $4,365.16 | |
Aetna
| Professional | $63.10 | $72.44 | $81.28 | |
Medica
| Facility | $79.43 | $123.03 | $194.98 | |
Medica
| Professional | $69.18 | $114.82 | $549.54 | |
Midlands
| Professional | $102.33 | $102.33 | $102.33 | |
United
| Facility | $812.83 | $812.83 | $812.83 | |
United
| Professional | $75.86 | $114.82 | $213.80 |