| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $36.90 | $36.90 | $36.90 | |
Hally Health
| Professional | $114.55 | $131.50 | $150.00 | |
Medica
| Facility | $41.94 | $41.94 | $41.94 | |
Medica
| Professional | $41.94 | $41.94 | $41.94 | |
Midlands
| Facility | $41.94 | $41.94 | $41.94 | |
Midlands
| Professional | $41.94 | $41.94 | $41.94 |