| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $30.00 | $30.00 | $37.50 | |
Medica
| Facility | $61.07 | $90.00 | $90.00 | |
Medica
| Professional | $119.42 | $119.42 | $119.42 | |
Midlands
| Facility | $48.41 | $48.41 | $48.41 | |
Midlands
| Professional | $40.64 | $48.41 | $66.30 |