| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $492.75 | $492.75 | $615.94 | |
Hally Health
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Professional | $747.85 | $747.85 | $747.85 | |
Midlands
| Professional | $747.85 | $747.85 | $747.85 |