| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $72.87 | $84.62 | $112.70 |
Cigna
| Facility | 26 | $83.32 | $83.32 | $83.32 |
Medcost
| Facility | 26 | $91.75 | $111.20 | $223.96 |
Wellcare
| Facility | 26 | $174.44 | $245.42 | $1,078.00 |