| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $162.19 | $313.64 | $467.14 | |
Medcost
| Professional | $122.00 | $122.00 | $122.00 | |
Wellcare
| Facility | $209.06 | $209.06 | $427.68 | |
Wellcare
| Professional | $398.58 | $2,940.00 | $2,940.00 |