| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $65.67 | $103.80 | $129.74 | |
Medica
| Facility | $83.33 | $83.33 | $199.32 | |
Medica
| Professional | $105.00 | $105.00 | $105.00 | |
Midlands
| Professional | $76.51 | $96.00 | $122.46 |