| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.95 | $24.95 | $24.95 | |
Aetna
| Professional | $24.95 | $24.95 | $24.95 | |
Cigna
| Professional | $24.75 | $27.68 | $30.94 | |
Medica
| Facility | $35.68 | $42.17 | $68.36 | |
Medica
| Professional | $22.00 | $32.29 | $32.29 | |
Midlands
| Facility | $38.08 | $39.02 | $41.89 | |
Midlands
| Professional | $30.31 | $39.39 | $52.21 | |
United
| Professional | $32.29 | $32.29 | $38.74 |