| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $195.00 | $195.00 | $243.75 | |
Medica
| Facility | $255.48 | $255.48 | $255.48 | |
Medica
| Professional | $616.66 | $616.66 | $616.66 | |
Midlands
| Facility | $322.20 | $322.20 | $354.06 | |
Midlands
| Professional | $322.20 | $354.06 | $459.86 |