| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $158.49 | $158.49 | $158.49 |
Cigna
| Facility | 26 | $38.02 | $177.83 | $257.04 |
Medcost
| Professional | 26 | $229.09 | $229.09 | $229.09 |
Wellcare
| Facility | 26 | $1,000.00 | $1,000.00 | $1,000.00 |