| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $85.70 | $85.70 | $107.13 | |
Medica
| Facility | $118.27 | $118.27 | $118.27 | |
Medica
| Professional | $115.00 | $187.53 | $474.21 | |
Midlands
| Facility | $95.78 | $133.13 | $205.51 | |
Midlands
| Professional | $80.38 | $144.00 | $205.51 |