| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $106.13 | $106.13 | $132.66 | |
Medica
| Facility | $298.45 | $420.38 | $420.38 | |
Medica
| Professional | $583.55 | $583.55 | $583.55 | |
Midlands
| Facility | $115.60 | $149.82 | $172.18 | |
Midlands
| Professional | $115.60 | $167.71 | $234.37 |