| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.74 | $29.74 | $29.74 | |
Aetna
| Professional | $29.74 | $29.74 | $29.74 | |
Cigna
| Professional | $232.88 | $291.08 | $872.98 | |
Medica
| Facility | $29.74 | $49.07 | $56.51 | |
Medica
| Professional | $36.47 | $36.47 | $36.47 | |
Midlands
| Facility | $36.47 | $36.47 | $36.47 | |
Midlands
| Professional | $36.47 | $36.47 | $36.47 |