| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $741.00 | $741.00 | $741.00 | |
Medica
| Facility | $77.42 | $77.42 | $77.42 | |
Midlands
| Facility | $500.13 | $500.13 | $583.49 | |
Midlands
| Professional | $200.99 | $200.99 | $200.99 | |
Wellmark
| Facility | $333.42 | $333.42 | $333.42 | |
Wellmark
| Professional | $333.42 | $333.42 | $333.42 |