| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $84.07 | $101.35 | $154.29 |
Cigna
| Facility | 26 | $106.76 | $106.76 | $106.76 |
Medcost
| Facility | 26 | $131.00 | $145.74 | $249.95 |
Wellcare
| Facility | 26 | $217.55 | $1,072.58 | $1,072.58 |