| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $101.55 | $118.17 | $179.90 |
Cigna
| Facility | 26 | $131.86 | $131.86 | $131.86 |
Medcost
| Facility | 26 | $156.71 | $181.00 | $316.42 |
Wellcare
| Facility | 26 | $260.70 | $556.61 | $556.61 |