| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $200.51 | $200.51 | $250.63 | |
Medica
| Facility | $520.20 | $520.20 | $520.20 | |
Medica
| Professional | $249.45 | $249.45 | $249.45 | |
Midlands
| Facility | $156.05 | $156.05 | $166.00 | |
Midlands
| Professional | $156.05 | $194.80 | $288.86 |