| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $303.30 | $303.30 | $379.12 | |
Hally Health
| Professional | $150.00 | $150.00 | $295.11 | |
Medica
| Facility | $174.00 | $174.00 | $174.00 | |
Medica
| Professional | $101.00 | $174.00 | $525.55 | |
Midlands
| Facility | $174.00 | $174.00 | $174.00 | |
Midlands
| Professional | $101.00 | $174.00 | $280.08 |