| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $795.00 | $795.00 | $795.00 | |
Aetna
| Professional | $795.00 | $1,182.72 | $1,224.04 | |
Cigna
| Professional | $4,077.00 | $4,117.77 | $5,096.25 | |
Medica
| Facility | $97.53 | $424.06 | $3,008.11 | |
Medica
| Professional | $38.58 | $71.48 | $159.41 | |
Midlands
| Facility | $189.53 | $190.65 | $432.54 | |
Midlands
| Professional | $189.53 | $196.69 | $355.53 | |
United
| Professional | $35.76 | $62.73 | $128.74 |