| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.00 | $40.00 | $40.00 | |
Aetna
| Professional | $40.00 | $40.00 | $40.00 | |
Cigna
| Professional | $50.00 | $50.00 | $50.00 | |
Medica
| Facility | $40.00 | $40.00 | $90.00 | |
Medica
| Professional | $40.00 | $40.00 | $40.00 | |
Midlands
| Facility | $690.57 | $690.57 | $690.57 | |
Midlands
| Professional | $599.65 | $599.65 | $690.57 |