| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.49 | $34.49 | $34.49 | |
Aetna
| Professional | $33.33 | $34.49 | $34.49 | |
Cigna
| Professional | $2.02 | $2.02 | $139.69 | |
Medica
| Facility | $33.65 | $56.33 | $91.32 | |
Midlands
| Facility | $139.69 | $139.69 | $139.69 | |
Midlands
| Professional | $126.87 | $139.69 | $139.69 |