| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $81.75 | $81.75 | $102.19 | |
Medica
| Professional | $165.32 | $165.32 | $165.32 | |
Midlands
| Facility | $96.23 | $96.23 | $96.23 | |
Midlands
| Professional | $58.90 | $96.23 | $165.32 |