| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.74 | $40.74 | $57.54 | |
Aetna
| Professional | $28.84 | $40.74 | $66.07 | |
Medica
| Facility | $43.65 | $61.66 | $85.11 | |
Medica
| Professional | $41.69 | $60.26 | $107.15 | |
Midlands
| Professional | $50.12 | $50.12 | $50.12 | |
United
| Professional | $43.65 | $60.26 | $93.33 |