| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $163.24 | $163.24 | $163.24 | |
Aetna
| Professional | $163.24 | $163.24 | $205.68 | |
Cigna
| Professional | $160.50 | $160.50 | $200.63 | |
Hally Health
| Professional | $103.04 | $150.00 | $290.41 | |
Medica
| Facility | $139.00 | $187.16 | $306.81 | |
Medica
| Professional | $145.53 | $186.43 | $195.97 | |
Midlands
| Facility | $139.00 | $145.36 | $187.16 | |
Midlands
| Professional | $126.87 | $144.09 | $215.35 | |
United
| Professional | $164.98 | $186.43 | $194.68 |