| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $38.29 | $83.20 | $110.32 | |
Medcost
| Professional | $27.00 | $27.00 | $27.00 | |
Wellcare
| Facility | $90.00 | $90.00 | $90.00 | |
Wellcare
| Professional | $122.00 | $122.00 | $5,919.01 |