| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $165.96 | $169.82 | $208.93 | |
Hally Health
| Professional | $151.36 | $151.36 | $151.36 | |
Medica
| Facility | $288.40 | $288.40 | $288.40 | |
Medica
| Professional | $245.47 | $245.47 | $245.47 |