| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.00 | $10.00 | $10.00 | |
Cigna
| Professional | $53.24 | $53.24 | $66.55 | |
Medica
| Facility | $10.00 | $10.50 | $90.00 | |
Medica
| Professional | $10.00 | $10.00 | $10.00 | |
Midlands
| Professional | $67.78 | $67.78 | $84.07 |