| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $82.33 | $90.49 | $137.76 |
Cigna
| Facility | 26 | $93.76 | $93.76 | $93.76 |
Medcost
| Facility | 26 | $113.00 | $124.31 | $253.82 |
Wellcare
| Facility | 26 | $593.12 | $746.48 | $746.48 |