| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $325.38 | $325.38 | $325.38 |
Cigna
| Facility | 26 | $369.73 | $369.73 | $369.73 |
Medcost
| Facility | 26 | $321.89 | $403.00 | $607.33 |
Wellcare
| Facility | 26 | $598.14 | $1,601.04 | $1,601.04 |