| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7.94 | $4,365.16 | $4,365.16 | |
Aetna
| Professional | $1.00 | $1.00 | $7.94 | |
Cigna
| Professional | $20.42 | $20.42 | $20.42 | |
Medica
| Facility | $2.51 | $3.02 | $22.39 | |
Midlands
| Professional | $20.42 | $20.42 | $20.42 | |
Midlands
| Professional | $20.42 | $20.42 | $20.42 | |
Wellmark
| Professional | $38.90 | $38.90 | $38.90 |