| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $164.27 | $164.27 | $205.34 | |
Medica
| Facility | $97.00 | $354.12 | $354.12 | |
Medica
| Professional | $97.00 | $133.66 | $191.21 | |
Midlands
| Facility | $75.00 | $113.50 | $182.22 | |
Midlands
| Professional | $97.00 | $141.83 | $193.72 |