| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $105.75 | $132.19 | $134.30 | |
Hally Health
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $137.56 | $137.56 | $137.56 | |
Medica
| Professional | $283.70 | $283.70 | $283.70 |