| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $256.82 | $300.11 | $460.38 | |
Cigna
| Professional | $117.71 | $251.13 | $285.38 | |
Medica
| Facility | $373.04 | $373.04 | $373.04 | |
Quartz
| Professional | $195.08 | $195.08 | $214.98 | |
Quartz
| Facility | $186.52 | $186.52 | $373.04 |