| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $83.06 | $83.06 | $83.06 | |
Medica
| Facility | $90.00 | $100.00 | $483.16 | |
Medica
| Professional | $134.21 | $134.21 | $134.21 | |
Midlands
| Professional | $134.21 | $366.46 | $366.46 | |
Wellmark
| Professional | $79.81 | $101.02 | $101.02 |