| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $139.69 | $139.69 | $174.62 | |
Medica
| Facility | $280.72 | $280.72 | $280.72 | |
Medica
| Professional | $280.72 | $280.72 | $280.72 | |
Midlands
| Facility | $122.82 | $144.57 | $179.66 | |
Midlands
| Professional | $122.82 | $144.57 | $179.66 |