| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $161.25 | $373.88 | $467.34 | |
Hally Health
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $472.25 | $472.25 | $8,898.65 | |
Medica
| Professional | $472.25 | $2,025.09 | $2,025.09 | |
Midlands
| Facility | $472.25 | $472.25 | $472.25 | |
Midlands
| Professional | $441.95 | $472.25 | $693.06 |