| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $104.30 | $215.37 | $269.22 | |
Medica
| Facility | $520.20 | $520.20 | $520.20 | |
Medica
| Professional | $180.66 | $194.80 | $200.44 | |
Midlands
| Facility | $156.05 | $180.66 | $196.00 | |
Midlands
| Professional | $136.88 | $184.76 | $266.32 |