| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $251.19 | $251.19 | $316.23 | |
Medcost
| Facility | $131.83 | $186.21 | $1,412.54 | |
Wellcare
| Facility | $1,513.56 | $1,513.56 | $1,513.56 | |
Wellcare
| Professional | $5,754.40 | $5,754.40 | $5,754.40 |