| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $28.88 | $28.88 | $36.09 | |
Hally Health
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Medica
| Professional | $126.81 | $126.81 | $126.81 | |
Midlands
| Professional | $26.46 | $44.10 | $44.10 |