| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,051.59 | $1,051.59 | $1,051.59 | |
Cigna
| Professional | $1,051.59 | $1,051.59 | $1,083.15 | |
Hally Health
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $100.00 | $590.84 | $980.62 |