| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $27.58 | $27.58 | $3,073.00 | |
Aetna
| Professional | $27.58 | $27.58 | $649.01 | |
Medica
| Facility | $27.58 | $140.02 | $1,298.02 | |
Midlands
| Facility | $492.44 | $574.51 | $791.18 | |
United
| Facility | $821.00 | $821.00 | $821.00 |