| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.82 | $162.18 | $162.18 | |
Aetna
| Professional | $128.82 | $138.04 | $218.78 | |
Cigna
| Professional | $141.25 | $141.25 | $177.83 | |
Medica
| Facility | $128.82 | $218.78 | $398.11 | |
Medica
| Professional | $107.15 | $331.13 | $331.13 | |
Midlands
| Professional | $177.83 | $177.83 | $177.83 | |
United
| Professional | $331.13 | $331.13 | $398.11 |