| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,338.00 | $4,338.00 | $4,338.00 | |
Aetna
| Professional | $1.78 | $1.78 | $1.78 | |
Medica
| Facility | $2.54 | $3.01 | $22.42 | |
Midlands
| Professional | $18.70 | $20.60 | $21.02 | |
Wellmark
| Professional | $39.25 | $39.25 | $39.25 |