| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $67.15 | $67.15 | $67.15 | |
BCBS
| Professional | $547.84 | $547.84 | $547.84 | |
Cigna
| Facility | $30.72 | $30.72 | $30.72 | |
Cigna
| Professional | $26.11 | $30.72 | $1,086.56 | |
Medcost
| Facility | $67.15 | $67.15 | $80.58 | |
Wellcare
| Facility | $100.00 | $186.11 | $200.43 |