| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,018.19 | $1,245.00 | $7,439.00 | |
Medcost
| Facility | $962.36 | $1,339.91 | $1,989.53 | |
Medcost
| Facility | AS | $163.60 | $187.59 | $278.50 |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $15,328.16 | $18,508.80 | |
Wellcare
| Facility | AS | $228.82 | $252.54 | $490.96 |