| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $404.20 | $3,071.68 | $7,090.66 | |
Aetna
| Facility | 52 | $120.30 | $649.61 | $1,038.46 |
Medcost
| Facility | $240.60 | $1,288.43 | $1,932.49 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $55.00 | $2,262.21 | $2,262.21 | |
Wellcare
| Facility | 52 | $930.74 | $930.74 | $930.74 |