| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $156.29 | $987.24 | $8,019.15 | |
Aetna
| Facility | 52 | $47.40 | $78.14 | $1,062.59 |
Medcost
| Facility | $94.79 | $1,107.35 | $2,289.58 | |
United
| Facility | $361.00 | $896.00 | $2,229.00 | |
Wellcare
| Facility | $55.00 | $455.15 | $455.15 | |
Wellcare
| Facility | 52 | $364.12 | $364.12 | $364.12 |