| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $274.13 | $276.87 | $342.66 | |
Hally Health
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $470.93 | $470.93 | $470.93 | |
Medica
| Professional | $398.37 | $398.37 | $398.37 | |
Midlands
| Professional | $398.37 | $398.37 | $398.37 |