| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $39.38 | $39.38 | $49.22 | |
Hally Health
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Medica
| Professional | $166.25 | $166.25 | $166.25 | |
Midlands
| Professional | $17.30 | $28.83 | $28.83 |