| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $61.66 | $72.44 | $114.82 | |
Cigna
| Professional | $28.18 | $35.48 | $42.66 | |
DeanCare
| Facility | $16.22 | $16.22 | $22.39 | |
Medica
| Facility | $16.22 | $16.22 | $22.39 | |
Quartz
| Facility | $60.26 | $60.26 | $104.71 |