| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $37.15 | $37.15 | $37.15 | |
Hally Health
| Professional | $114.82 | $131.83 | $151.36 | |
Medica
| Facility | $41.69 | $41.69 | $41.69 | |
Medica
| Professional | $41.69 | $41.69 | $41.69 | |
Midlands
| Professional | $41.69 | $41.69 | $41.69 |