| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.10 | $114.10 | $321.89 | |
Aetna
| Professional | $94.85 | $114.10 | $121.24 | |
Cigna
| Facility | $108.38 | $198.47 | $374.53 | |
Medcost
| Facility | $114.10 | $142.63 | $213.95 | |
Medcost
| Professional | $92.71 | $92.71 | $142.63 | |
United
| Professional | $59.90 | $85.58 | $142.63 | |
Wellcare
| Facility | $248.18 | $677.49 | $677.49 | |
Wellcare
| Professional | $713.15 | $713.15 | $1,069.73 |