| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.00 | $3.00 | $3.00 | |
Aetna
| Professional | $3.00 | $3.00 | $3.00 | |
Cigna
| Professional | $8.50 | $8.50 | $8.50 | |
Medica
| Facility | $3.00 | $4.95 | $5.70 | |
Medica
| Professional | $45.07 | $45.07 | $52.85 | |
Midlands
| Facility | $50.70 | $52.85 | $52.85 | |
Midlands
| Professional | $46.03 | $49.33 | $52.85 |