| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $114.18 | $114.18 | $142.72 | |
Medcost
| Facility | $43.82 | $46.82 | $147.02 | |
Wellcare
| Facility | $163.28 | $290.49 | $290.49 | |
Wellcare
| Professional | $401.49 | $401.49 | $401.49 |