| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $83.18 | $154.88 | $363.08 |
Cigna
| Facility | 26 | $22.91 | $107.15 | $151.36 |
Medcost
| Professional | 26 | $144.54 | $177.83 | $204.17 |
Wellcare
| Facility | 26 | $1,071.52 | $1,071.52 | $1,071.52 |