| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $302.00 | $302.00 | $371.54 | |
Hally Health
| Professional | $151.36 | $151.36 | $416.87 | |
Medica
| Facility | $269.15 | $302.00 | $436.52 | |
Medica
| Professional | $257.04 | $281.84 | $1,023.29 |