| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $42.02 | $57.71 | $57.71 | |
Cigna
| Facility | $46.80 | $46.80 | $50.70 | |
Cigna
| Professional | $46.80 | $46.80 | $92.25 | |
Medcost
| Facility | $26.42 | $57.71 | $70.00 | |
Medcost
| Professional | $59.00 | $59.00 | $59.00 | |
United
| Professional | $31.45 | $43.09 | $71.92 | |
Wellcare
| Facility | $100.00 | $380.20 | $380.20 |