| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $75.00 | $75.00 | $93.75 | |
Medica
| Facility | $200.00 | $200.00 | $200.00 | |
Midlands
| Facility | $100.00 | $101.25 | $151.57 | |
Midlands
| Professional | $100.00 | $151.57 | $195.75 |