| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $73.75 | $133.40 | $213.73 | |
Medica
| Facility | $677.00 | $677.00 | $677.00 | |
Medica
| Professional | $317.00 | $418.89 | $418.89 | |
Midlands
| Facility | $99.56 | $125.05 | $133.00 | |
Midlands
| Professional | $84.22 | $125.05 | $169.90 |