| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $150.05 | $150.05 | $150.05 | |
Aetna
| Professional | $150.05 | $150.05 | $153.62 | |
Medica
| Facility | $219.68 | $253.58 | $259.62 | |
Medica
| Professional | $178.26 | $299.11 | $1,169.68 | |
Midlands
| Facility | $181.44 | $200.75 | $244.74 | |
Midlands
| Professional | $200.75 | $244.74 | $809.16 | |
United
| Professional | $201.54 | $284.04 | $331.38 |