| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.00 | $20.00 | $20.00 | |
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
Cigna
| Professional | $18.38 | $22.97 | $28.91 | |
Medica
| Facility | $20.00 | $33.00 | $38.00 | |
Medica
| Professional | $9.36 | $22.50 | $22.50 | |
Midlands
| Facility | $9.36 | $9.36 | $25.27 | |
Midlands
| Professional | $9.36 | $22.95 | $24.59 |