| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.90 | $50.90 | $50.90 | |
Cigna
| Professional | $0.80 | $0.80 | $0.80 | |
Medcost
| Facility | $72.00 | $72.00 | $72.00 | |
United
| Professional | $37.00 | $37.00 | $37.00 | |
Wellcare
| Facility | $100.00 | $100.00 | $149.05 |