| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.82 | $338.84 | $6,918.31 | |
Medcost
| Professional | $204.17 | $204.17 | $204.17 | |
Medcost
| Facility | $89.13 | $117.49 | $165.96 | |
United
| Facility | $363.08 | $812.83 | $1,949.84 | |
Wellcare
| Facility | $562.34 | $562.34 | $19,498.45 | |
Wellcare
| Facility | AS | $56.23 | $56.23 | $56.23 |