| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $296.10 | $296.10 | $296.10 | |
Aetna
| Professional | $296.10 | $358.26 | $455.90 | |
Cigna
| Professional | $558.75 | $564.34 | $698.44 | |
Medica
| Facility | $30.35 | $80.00 | $981.63 | |
Medica
| Professional | $19.29 | $24.24 | $40.40 | |
Midlands
| Facility | $56.79 | $58.12 | $131.02 | |
Midlands
| Professional | $56.79 | $62.96 | $116.64 | |
United
| Professional | $17.50 | $24.24 | $38.58 |