| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $44.67 | $44.67 | $44.67 |
Cigna
| Facility | 26 | $10.96 | $50.12 | $72.44 |
Medcost
| Professional | 26 | $85.11 | $85.11 | $85.11 |
Wellcare
| Facility | 26 | $288.40 | $288.40 | $288.40 |