| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $46.77 | $46.77 | $57.54 | |
Medica
| Professional | $354.81 | $354.81 | $354.81 | |
Midlands
| Professional | $213.80 | $213.80 | $213.80 | |
Midlands
| Professional | $213.80 | $213.80 | $213.80 |