| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $37.11 | $80.59 | $106.87 | |
Medcost
| Professional | $28.00 | $28.00 | $28.00 | |
Wellcare
| Facility | $56.19 | $122.72 | $139.63 | |
Wellcare
| Professional | $109.87 | $109.87 | $140.99 |