| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $84.95 | $84.95 | $84.95 | |
Aetna
| Professional | $84.19 | $84.95 | $84.95 | |
Medica
| Facility | $84.95 | $143.57 | $211.59 | |
Midlands
| Professional | $154.91 | $154.91 | $345.32 | |
United
| Facility | $233.00 | $233.00 | $233.00 | |
Wellmark
| Professional | $153.00 | $153.00 | $153.00 |