| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $62.18 | $72.66 | $111.46 | |
Cigna
| Professional | $28.50 | $35.61 | $165.85 | |
DeanCare
| Facility | $16.07 | $16.07 | $22.12 | |
Medica
| Facility | $16.07 | $16.07 | $22.12 | |
Prevea360
| Facility | $16.07 | $16.07 | $22.12 | |
Quartz
| Facility | $60.00 | $60.00 | $176.95 |