| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.92 | $45.86 | $137.58 | |
Aetna
| Professional | $36.34 | $45.86 | $88.40 | |
Cigna
| Professional | $14.86 | $48.75 | $60.94 | |
Medcost
| Facility | $37.29 | $45.86 | $49.07 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |