| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $22.51 | $22.51 | $22.51 | |
BCBS
| Professional | $97.72 | $97.72 | $97.72 | |
Cigna
| Facility | $77.00 | $77.00 | $85.00 | |
Cigna
| Professional | $20.89 | $85.00 | $192.19 | |
Medcost
| Facility | $22.51 | $25.44 | $75.00 | |
Wellcare
| Facility | $120.00 | $120.00 | $120.00 |