| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $168.20 | $240.53 | $7,439.00 | |
Medcost
| Facility | $159.07 | $219.84 | $328.86 | |
Medcost
| Facility | AS | $27.04 | $30.78 | $46.03 |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $381.17 | $793.82 | |
Wellcare
| Facility | AS | $38.11 | $41.18 | $79.38 |