| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $238.98 | $238.98 | $238.98 | |
Cigna
| Facility | $180.13 | $180.13 | $180.13 | |
Cigna
| Professional | $180.13 | $180.13 | $180.13 | |
Medica
| Facility | $238.98 | $238.98 | $406.27 | |
Medica
| Professional | $287.22 | $287.22 | $287.22 | |
Midlands
| Professional | $490.65 | $490.65 | $562.05 |