| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $517.29 | $517.29 | $517.29 | |
Aetna
| Professional | $517.29 | $550.00 | $636.39 | |
Medica
| Facility | $874.24 | $925.65 | $1,075.50 | |
Midlands
| Professional | $300.25 | $300.25 | $300.25 | |
Wellmark
| Professional | $250.00 | $250.00 | $250.00 |