| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $68.67 | $83.91 | $127.74 |
Cigna
| Facility | 26 | $87.50 | $87.50 | $87.50 |
Medcost
| Facility | 26 | $121.62 | $136.00 | $236.09 |
Wellcare
| Facility | 26 | $180.94 | $371.26 | $371.26 |