| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $103.86 | $150.11 | $150.11 | |
Cigna
| Facility | $123.59 | $123.59 | $123.59 | |
Cigna
| Professional | $113.17 | $123.59 | $222.38 | |
Medcost
| Facility | $100.84 | $150.11 | $235.28 | |
Medcost
| Professional | $202.00 | $202.00 | $202.00 | |
United
| Professional | $94.83 | $123.55 | $204.47 | |
Wellcare
| Facility | $291.01 | $922.40 | $922.40 |