| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $48.63 | $112.05 | $298.20 | |
Medcost
| Professional | $78.00 | $78.00 | $78.00 | |
Wellcare
| Facility | $90.00 | $90.00 | $90.00 | |
Wellcare
| Professional | $116.87 | $145.53 | $304.19 |