| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $203.35 | $203.35 | $254.18 | |
Medica
| Facility | $166.52 | $210.18 | $430.80 | |
Medica
| Professional | $184.00 | $760.58 | $760.58 | |
Midlands
| Facility | $115.23 | $115.23 | $184.00 | |
Midlands
| Professional | $115.23 | $175.00 | $201.75 |