| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $426.58 | $426.58 | $537.03 | |
Hally Health
| Professional | $151.36 | $151.36 | $389.05 | |
Medica
| Facility | $169.82 | $229.09 | $389.05 | |
Medica
| Professional | $120.23 | $218.78 | $724.44 |