| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.10 | $96.10 | $96.10 | |
Aetna
| Professional | $69.12 | $96.10 | $205.08 | |
Cigna
| Professional | $20.93 | $20.93 | $20.93 | |
Medica
| Facility | $98.73 | $162.41 | $197.46 | |
Midlands
| Professional | $140.52 | $140.52 | $140.52 | |
Wellmark
| Professional | $74.00 | $74.00 | $74.00 |