| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.14 | $39.81 | $8,709.64 | |
Medcost
| Facility | $15.85 | $23.99 | $39.81 | |
United
| Facility | $363.08 | $812.83 | $1,949.84 | |
Wellcare
| Facility | $56.23 | $1,288.25 | $1,288.25 | |
Wellcare
| Facility | AS | $9.77 | $9.77 | $9.77 |