| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.62 | $27.04 | $27.04 | |
Aetna
| Professional | $19.50 | $19.50 | $19.50 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $79.34 | $79.34 | $116.19 | |
Medcost
| Facility | $49.24 | $50.00 | $52.00 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |