| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $28.18 | $41.69 | $117.49 |
Cigna
| Facility | 26 | $9.55 | $44.67 | $63.10 |
Medcost
| Professional | 26 | $47.86 | $47.86 | $47.86 |
Wellcare
| Facility | 26 | $239.88 | $239.88 | $239.88 |