| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $293.39 | $608.39 | $608.39 | |
Aetna
| Professional | $233.24 | $293.39 | $293.39 | |
Cigna
| Professional | $251.25 | $251.25 | $314.06 | |
Medica
| Facility | $146.78 | $495.85 | $725.11 | |
Midlands
| Facility | $376.94 | $376.94 | $376.94 | |
Midlands
| Professional | $342.29 | $376.94 | $386.72 | |
Wellmark
| Professional | $255.80 | $255.80 | $255.80 |