| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $156.54 | $156.54 | $187.56 | |
Medcost
| Professional | $47.00 | $47.00 | $47.00 | |
Wellcare
| Facility | $85.00 | $99.11 | $127.42 | |
Wellcare
| Professional | $173.00 | $177.19 | $177.19 |