| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.50 | $162.50 | $162.50 | |
Aetna
| Professional | $134.88 | $162.50 | $162.50 | |
Cigna
| Professional | $142.88 | $142.88 | $178.59 | |
Medica
| Facility | $127.70 | $218.79 | $400.73 | |
Medica
| Professional | $106.42 | $332.96 | $366.26 | |
Midlands
| Facility | $127.70 | $136.96 | $202.01 | |
Midlands
| Professional | $123.13 | $179.10 | $275.25 | |
United
| Professional | $332.96 | $332.96 | $366.26 |