| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.02 | $3.02 | $3.02 | |
Aetna
| Professional | $3.02 | $3.02 | $3.02 | |
Cigna
| Professional | $8.51 | $8.51 | $51.29 | |
Medica
| Facility | $3.02 | $5.13 | $8.13 | |
Midlands
| Professional | $51.29 | $51.29 | $51.29 | |
Midlands
| Professional | $51.29 | $51.29 | $51.29 | |
Wellmark
| Professional | $43.65 | $43.65 | $43.65 |