| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $30.20 | $56.23 | $117.49 |
Cigna
| Facility | 26 | $7.76 | $36.31 | $51.29 |
Medcost
| Professional | 26 | $61.66 | $61.66 | $61.66 |
Wellcare
| Facility | 26 | $213.80 | $213.80 | $213.80 |