| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.00 | $45.00 | $45.00 | |
Aetna
| Professional | $45.00 | $45.00 | $45.00 | |
Cigna
| Facility | $379.93 | $379.93 | $379.93 | |
Cigna
| Professional | $379.93 | $379.93 | $379.93 | |
Medica
| Facility | $45.00 | $76.50 | $90.00 | |
Medica
| Professional | $45.00 | $45.00 | $45.00 | |
Midlands
| Facility | $2,787.50 | $2,787.50 | $2,787.50 | |
Midlands
| Professional | $2,428.77 | $2,428.77 | $2,787.50 |