| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $147.13 | $186.05 | $232.56 | |
Medica
| Facility | $192.12 | $373.04 | $373.04 | |
Medica
| Professional | $192.12 | $192.12 | $192.12 | |
Midlands
| Facility | $192.12 | $192.12 | $238.75 | |
Midlands
| Professional | $192.12 | $192.12 | $192.12 |