| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $750.00 | $750.00 | $750.00 | |
Cigna
| Professional | $750.00 | $750.00 | $937.50 | |
Medica
| Facility | $900.75 | $1,125.18 | $1,760.28 | |
Medica
| Professional | $1,125.18 | $1,177.71 | $1,637.38 | |
Midlands
| Facility | $921.28 | $1,177.71 | $1,780.64 | |
Midlands
| Professional | $921.28 | $1,177.71 | $1,637.38 |