| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $102.64 | $102.64 | $242.65 |
Cigna
| Facility | 26 | $117.01 | $117.01 | $117.01 |
Medcost
| Facility | 26 | $159.75 | $246.41 | $317.18 |
Wellcare
| Facility | 26 | $244.48 | $244.48 | $499.51 |