| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $112.50 | $112.50 | $140.63 | |
Medica
| Facility | $115.56 | $115.56 | $541.45 | |
Medica
| Professional | $143.00 | $143.00 | $143.00 | |
Midlands
| Professional | $112.28 | $167.78 | $203.07 |