| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $78.06 | $130.22 | $130.22 | |
Cigna
| Facility | $114.47 | $114.47 | $140.40 | |
Cigna
| Professional | $100.12 | $114.47 | $202.50 | |
Medcost
| Facility | $74.70 | $130.22 | $195.30 | |
Medcost
| Professional | $167.00 | $167.00 | $167.00 | |
United
| Professional | $72.56 | $102.30 | $203.39 | |
Wellcare
| Facility | $205.45 | $821.01 | $821.01 |