| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $30.11 | $30.11 | $37.64 | |
Medica
| Facility | $17.00 | $17.00 | $17.00 | |
Medica
| Professional | $17.00 | $25.60 | $48.74 | |
Midlands
| Facility | $17.00 | $28.78 | $40.19 | |
Midlands
| Professional | $17.00 | $28.78 | $48.74 |