| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $412.99 | $412.99 | $412.99 | |
Cigna
| Facility | $296.00 | $296.00 | $296.00 | |
Medica
| Facility | $412.99 | $412.99 | $702.08 | |
Medica
| Professional | $269.52 | $269.52 | $269.52 | |
Midlands
| Professional | $206.17 | $206.17 | $236.60 |