| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $155.13 | $155.13 | $193.93 | |
Medica
| Facility | $346.11 | $346.11 | $346.11 | |
Medica
| Professional | $114.00 | $683.00 | $683.00 | |
Midlands
| Facility | $110.20 | $138.41 | $176.94 | |
Midlands
| Professional | $110.20 | $138.41 | $187.63 |