| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.11 | $85.11 | $234.42 | |
Aetna
| Professional | $66.07 | $87.10 | $104.71 | |
BCBS
| Professional | $85.11 | $95.50 | $275.42 | |
Medcost
| Facility | $83.18 | $91.20 | $138.04 | |
United
| Facility | $97.72 | $97.72 | $97.72 | |
United
| Professional | $48.98 | $89.13 | $173.78 | |
Wellcare
| Facility | $562.34 | $562.34 | $562.34 | |
Wellcare
| Professional | $562.34 | $691.83 | $691.83 |