| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $42.66 | $93.33 | $123.03 | |
Medcost
| Professional | $38.90 | $38.90 | $66.07 | |
Wellcare
| Facility | $173.78 | $173.78 | $173.78 | |
Wellcare
| Professional | $245.47 | $245.47 | $245.47 |