| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $13.91 | $13.91 | $16.67 | |
Medcost
| Professional | $16.00 | $16.00 | $16.00 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 | |
Wellcare
| Professional | $1,514.66 | $1,514.66 | $1,514.66 |