| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $408.46 | $408.46 | $408.46 |
Cigna
| Facility | 26 | $462.59 | $462.59 | $462.59 |
Medcost
| Facility | 26 | $429.01 | $519.00 | $771.91 |
Wellcare
| Facility | 26 | $743.33 | $2,977.00 | $3,485.00 |