| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $174.93 | $174.93 | $174.93 | |
Aetna
| Professional | $174.93 | $174.93 | $196.55 | |
Cigna
| Professional | $216.75 | $216.75 | $270.94 | |
Medica
| Facility | $132.13 | $281.07 | $538.54 | |
Medica
| Professional | $144.94 | $181.32 | $291.38 | |
Midlands
| Facility | $210.65 | $230.33 | $257.16 | |
Midlands
| Professional | $210.65 | $235.17 | $353.93 | |
United
| Professional | $144.94 | $248.83 | $342.86 |