| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $25.46 | $25.46 | $31.83 | |
Hally Health
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $34.36 | $34.36 | $90.00 | |
Medica
| Professional | $25.46 | $34.36 | $79.48 | |
Midlands
| Facility | $25.46 | $34.36 | $34.36 | |
Midlands
| Professional | $25.46 | $34.36 | $66.45 |