| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $322.95 | $2,043.00 | $6,953.60 | |
Cigna
| Facility | $606.10 | $606.10 | $606.10 | |
Medcost
| Facility | $322.95 | $464.10 | $613.28 | |
Medcost
| Facility | AS | $63.41 | $64.97 | $106.71 |
United
| Facility | $117.00 | $896.00 | $2,229.00 | |
Wellcare
| Facility | $4,381.16 | $5,214.58 | $5,214.58 | |
Wellcare
| Facility | AS | $45.83 | $79.78 | $157.94 |