| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.26 | $1.26 | $1.26 | |
Aetna
| Professional | $1.26 | $1.26 | $1.26 | |
Cigna
| Professional | $191.26 | $191.26 | $191.26 | |
Medica
| Facility | $2.12 | $2.13 | $3.45 | |
Midlands
| Professional | $350.07 | $402.57 | $402.57 | |
Wellmark
| Professional | $335.20 | $335.20 | $335.20 |