| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $16.98 | $21.88 | $21.88 | |
Cigna
| Facility | $20.89 | $20.89 | $22.39 | |
Cigna
| Professional | $17.78 | $20.89 | $46.77 | |
Medcost
| Professional | $16.60 | $17.78 | $17.78 | |
Medcost
| Facility | $10.23 | $22.39 | $30.90 | |
United
| Facility | $1.38 | $10.47 | $19.95 | |
United
| Professional | $10.47 | $16.60 | $26.30 | |
Wellcare
| Facility | $100.00 | $147.91 | $147.91 |