| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $162.75 | $162.75 | $203.44 | |
Medica
| Facility | $1,097.59 | $1,097.59 | $1,097.59 | |
Midlands
| Facility | $194.42 | $194.42 | $201.87 | |
Midlands
| Professional | $194.42 | $260.08 | $346.88 |