| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $124.87 | $138.46 | $223.39 |
Cigna
| Facility | 26 | $142.61 | $142.61 | $142.61 |
Medcost
| Facility | 26 | $154.61 | $233.00 | $278.38 |
Wellcare
| Facility | 26 | $896.96 | $1,133.76 | $1,133.76 |