| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $93.33 | $123.03 | $181.97 | |
Medcost
| Professional | $87.10 | $87.10 | $87.10 | |
Medcost
| Facility | $46.77 | $77.62 | $114.82 | |
Wellcare
| Facility | $660.69 | $660.69 | $660.69 | |
Wellcare
| Professional | $302.00 | $371.54 | $371.54 |