| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $88.32 | $106.92 | $162.77 |
Cigna
| Facility | 26 | $113.90 | $113.90 | $113.90 |
Medcost
| Facility | 26 | $146.63 | $165.97 | $221.79 |
Wellcare
| Facility | 26 | $229.64 | $481.98 | $481.98 |