| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $70.05 | $88.39 | $147.21 |
Cigna
| Facility | 26 | $100.40 | $100.40 | $100.40 |
Medcost
| Facility | 26 | $67.70 | $106.00 | $181.65 |
Wellcare
| Facility | 26 | $204.35 | $425.03 | $425.03 |