| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $166.41 | $167.46 | $254.93 |
Cigna
| Facility | 26 | $189.68 | $189.68 | $189.68 |
Medcost
| Facility | 26 | $199.04 | $233.15 | $426.13 |
Wellcare
| Facility | 26 | $731.04 | $827.26 | $827.26 |