| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $158.21 | $158.21 | $158.21 |
Cigna
| Facility | 26 | $181.80 | $181.80 | $181.80 |
Medcost
| Facility | 26 | $149.72 | $203.00 | $282.02 |
Wellcare
| Facility | 26 | $342.00 | $777.77 | $777.77 |