| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $512.86 | $512.86 | $512.86 | |
Cigna
| Facility | $851.14 | $851.14 | $851.14 | |
Medcost
| Professional | $676.08 | $676.08 | $676.08 | |
Medcost
| Facility | $478.63 | $602.56 | $933.25 | |
Wellcare
| Facility | $3,311.31 | $3,311.31 | $3,311.31 |