| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $309.03 | $309.03 | $389.05 | |
Hally Health
| Professional | $151.36 | $151.36 | $295.12 | |
Medica
| Facility | $173.78 | $173.78 | $173.78 | |
Medica
| Professional | $100.00 | $173.78 | $524.81 |