| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $44.89 | $97.50 | $129.28 | |
Medcost
| Professional | $35.00 | $35.00 | $35.00 | |
Wellcare
| Facility | $90.00 | $90.00 | $90.00 | |
Wellcare
| Professional | $128.10 | $245.65 | $245.65 |