| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.74 | $21.26 | $64.26 | |
Aetna
| Professional | $50.90 | $50.90 | $50.90 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $28.35 | $28.35 | $28.35 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |