| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.57 | $1.57 | $1.57 | |
Cigna
| Professional | $10.13 | $10.33 | $12.66 | |
Medica
| Facility | $1.57 | $4.30 | $36.00 | |
Medica
| Professional | $24.00 | $38.40 | $50.40 | |
Midlands
| Professional | $28.83 | $28.83 | $28.83 | |
United
| Professional | $25.07 | $41.52 | $50.40 | |
Wellmark
| Professional | $15.00 | $15.00 | $15.00 |