| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $82.50 | $104.78 | $163.13 | |
Medica
| Facility | $134.18 | $134.18 | $134.18 | |
Medica
| Professional | $164.06 | $164.06 | $527.02 | |
Midlands
| Facility | $147.24 | $147.24 | $164.91 | |
Midlands
| Professional | $147.24 | $164.91 | $164.91 |