| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $467.74 | $467.74 | $588.84 | |
Hally Health
| Professional | $151.36 | $151.36 | $151.36 | |
Medica
| Facility | $575.44 | $575.44 | $575.44 | |
Medica
| Professional | $295.12 | $489.78 | $870.96 |