| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $188.60 | $188.60 | $188.60 | |
Aetna
| Professional | $128.38 | $188.60 | $196.50 | |
BCBS
| Professional | $175.46 | $175.46 | $219.33 | |
Medcost
| Facility | $176.78 | $188.60 | $207.77 | |
Medcost
| Professional | $182.09 | $184.43 | $184.43 | |
United
| Professional | $184.85 | $221.32 | $380.66 | |
Wellcare
| Facility | $402.07 | $999.31 | $999.31 |