| 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
| Facility | $347.00 | $347.00 | $433.75 | |
Cigna
| Professional | $232.88 | $235.20 | $291.08 | |
Medica
| Facility | $50.26 | $50.26 | $62.82 | |
Midlands
| Professional | $36.47 | $36.47 | $36.47 | |
Wellmark
| Professional | $27.45 | $27.45 | $27.45 |