| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $45.71 | $87.10 | $204.17 |
Cigna
| Facility | 26 | $12.59 | $58.88 | $83.18 |
Medcost
| Professional | 26 | $100.00 | $100.00 | $100.00 |
Wellcare
| Facility | 26 | $323.59 | $323.59 | $323.59 |