| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $203.95 | $203.95 | $203.95 | |
Aetna
| Professional | $181.85 | $181.85 | $203.95 | |
Medica
| Facility | $261.23 | $320.42 | $383.00 | |
Medica
| Professional | $215.20 | $337.00 | $1,293.17 | |
Midlands
| Facility | $169.24 | $258.89 | $373.77 | |
Midlands
| Professional | $235.42 | $258.89 | $373.77 | |
United
| Professional | $190.56 | $327.89 | $364.32 |