| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $184.38 | $184.38 | $184.38 | |
Aetna
| Professional | $184.38 | $221.34 | $221.34 | |
Medica
| Facility | $263.66 | $374.06 | $606.47 | |
Midlands
| Facility | $1,302.50 | $1,302.50 | $1,519.58 |