| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $85.72 | $94.54 | $143.91 |
Cigna
| Facility | 26 | $97.61 | $97.61 | $97.61 |
Medcost
| Facility | 26 | $122.00 | $139.38 | $241.76 |
Wellcare
| Facility | 26 | $617.36 | $777.44 | $777.44 |