| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $352.34 | $411.73 | $631.61 | |
Cigna
| Professional | $198.43 | $248.04 | $421.84 | |
Medica
| Professional | $525.55 | $525.55 | $525.55 | |
Quartz
| Facility | $424.02 | $424.02 | $424.02 | |
Quartz
| Professional | $304.33 | $525.55 | $525.55 |