| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $247.40 | $247.40 | $247.40 | |
Cigna
| Facility | $170.83 | $170.83 | $170.83 | |
Cigna
| Professional | $170.83 | $170.83 | $170.83 | |
Medica
| Facility | $247.40 | $247.40 | $420.58 | |
Medica
| Professional | $243.71 | $243.71 | $243.71 | |
Midlands
| Professional | $471.01 | $471.01 | $541.65 |