| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $49.38 | $113.77 | $389.57 | |
Medcost
| Professional | $99.00 | $99.00 | $99.00 | |
Wellcare
| Facility | $90.00 | $90.00 | $90.00 | |
Wellcare
| Professional | $119.81 | $342.16 | $364.11 |