| 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 | $341.03 | $578.83 | $690.11 | |
Medica
| Professional | $444.09 | $695.51 | $1,293.17 | |
Midlands
| Facility | $231.23 | $452.94 | $618.30 | |
Midlands
| Professional | $373.77 | $485.56 | $618.30 | |
United
| Professional | $223.19 | $665.61 | $751.90 |