| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.05 | $18.05 | $18.05 | |
Aetna
| Professional | $18.05 | $18.05 | $21.66 | |
BCBS
| Facility | $11.23 | $11.23 | $12.99 | |
Cigna
| Professional | $11.90 | $11.90 | $11.90 | |
Medcost
| Facility | $14.25 | $16.41 | $21.66 | |
Medcost
| Professional | $14.25 | $14.25 | $14.25 | |
Wellcare
| Facility | $80.00 | $85.00 | $100.00 | |
Wellcare
| Professional | $96.82 | $96.82 | $114.66 |