| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $34.13 | $34.13 | $34.13 | |
Medica
| Facility | $137.13 | $137.13 | $137.13 | |
Medica
| Professional | $56.90 | $199.62 | $199.62 | |
Midlands
| Facility | $56.90 | $56.90 | $56.90 | |
Midlands
| Professional | $56.90 | $56.90 | $73.19 |