| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $531.89 | $938.10 | $947.19 | |
Aetna
| Professional | $531.89 | $531.89 | $737.93 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Medcost
| Facility | $531.89 | $531.89 | $851.02 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |