| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $59.28 | $59.28 | $59.28 | |
Cigna
| Facility | $526.69 | $526.69 | $526.69 | |
Cigna
| Professional | $447.69 | $526.69 | $526.69 | |
Medcost
| Facility | $59.28 | $59.28 | $71.14 | |
Wellcare
| Facility | $80.00 | $100.00 | $100.00 |