| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $137.06 | $297.70 | $394.74 | |
Medcost
| Professional | $100.00 | $100.00 | $100.00 | |
Wellcare
| Facility | $205.30 | $205.30 | $205.30 | |
Wellcare
| Professional | $401.42 | $414.09 | $414.09 |