| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.04 | $138.04 | $138.04 | |
Aetna
| Professional | $123.03 | $138.04 | $158.49 | |
Cigna
| Professional | $181.97 | $199.53 | $363.08 | |
Hally Health
| Professional | $151.36 | $151.36 | $151.36 | |
Medica
| Facility | $181.97 | $213.80 | $707.95 | |
Medica
| Professional | $177.83 | $234.42 | $812.83 | |
Midlands
| Professional | $181.97 | $199.53 | $245.47 | |
United
| Professional | $165.96 | $234.42 | $457.09 |