| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $11.15 | $17.63 | $22.03 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Medica
| Professional | $24.00 | $24.00 | $24.00 | |
Midlands
| Facility | $11.75 | $11.75 | $21.32 | |
Midlands
| Professional | $16.45 | $22.00 | $27.64 |