| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $53.12 | $102.15 | $230.99 | |
Medcost
| Professional | $60.00 | $60.00 | $60.00 | |
Wellcare
| Facility | $90.00 | $90.00 | $90.00 | |
Wellcare
| Professional | $125.79 | $179.69 | $364.15 |