| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $169.82 | $169.82 | $208.93 | |
Hally Health
| Professional | $151.36 | $151.36 | $199.53 | |
Medica
| Facility | $144.54 | $144.54 | $1,047.13 | |
Medica
| Professional | $131.83 | $158.49 | $426.58 |