| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $14.82 | $14.82 | $14.82 | |
Cigna
| Professional | $130.77 | $130.77 | $130.77 | |
Hally Health
| Professional | $135.91 | $135.91 | $150.00 | |
Medica
| Facility | $22.82 | $125.71 | $186.02 | |
Midlands
| Facility | $104.54 | $125.71 | $167.95 |