| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.57 | $87.57 | $87.57 | |
Aetna
| Professional | $87.57 | $87.57 | $755.47 | |
Medica
| Facility | $147.99 | $642.15 | $1,510.94 | |
Midlands
| Professional | $396.91 | $493.61 | $493.61 | |
Wellmark
| Professional | $371.10 | $382.20 | $382.20 |