| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $78.37 | $89.03 | $135.54 |
Cigna
| Facility | 26 | $102.86 | $102.86 | $102.86 |
Medcost
| Facility | 26 | $123.15 | $136.00 | $232.62 |
Wellcare
| Facility | 26 | $586.17 | $710.22 | $710.22 |