| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $129.63 | $129.63 | $129.63 | |
Cigna
| Professional | $173.25 | $173.25 | $216.56 | |
Medica
| Facility | $267.85 | $358.86 | $358.86 | |
Midlands
| Facility | $200.00 | $200.00 | $266.88 | |
Midlands
| Professional | $200.00 | $224.00 | $408.00 |