| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.90 | $50.90 | $50.90 | |
Cigna
| Professional | $967.96 | $967.96 | $967.96 | |
Medcost
| Facility | $960.00 | $960.00 | $960.00 | |
Medcost
| Professional | $881.25 | $881.25 | $881.25 | |
Wellcare
| Facility | $100.00 | $100.00 | $372.97 |