| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $204.38 | $204.38 | $255.47 | |
Medica
| Professional | $1,080.20 | $1,080.20 | $1,080.20 | |
Midlands
| Facility | $276.43 | $330.51 | $410.73 | |
Midlands
| Professional | $276.43 | $431.67 | $431.67 |