| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $9.00 | $9.00 | $11.25 | |
Medica
| Facility | $1.00 | $1.00 | $3.77 | |
Medica
| Professional | $3.77 | $16.63 | $16.63 | |
Midlands
| Facility | $0.90 | $1.00 | $3.77 | |
Midlands
| Professional | $3.77 | $16.63 | $16.63 |