| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $476.76 | $2,439.00 | $7,026.55 | |
Aetna
| Facility | 52 | $91.40 | $151.10 | $335.86 |
Medcost
| Facility | $182.80 | $453.85 | $1,107.86 | |
United
| Facility | $3,366.00 | $9,541.00 | $14,589.00 | |
Wellcare
| Facility | $1,463.77 | $1,463.77 | $16,394.00 | |
Wellcare
| Facility | 52 | $713.38 | $713.38 | $713.38 |